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BUSINESS CERTIFICATE#05'/3 <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> • TOWNOFMASHPEE <br /> DAT a 3 2 O <br /> Expiration Date: December 31, 2009 <br /> In conformity with the provisions of Chapter one hundred and ten, Section five of the General Laws, as amended, the <br /> undersigned hereby declare(s)that a business under the title of <br /> 1312 UCtS- 12(=G A'-j - DBA lc-irA�- 7y57rris conducted at <br /> Business Location: /6 / 60, S'A-doc n cg KO <br /> Business Mailing Address: /(o / fs, SA-A✓0t-4cey- 90 ArAIrlFf,CA <br /> Business Type: OI C rTrL t yS7hm f Business Telephone: -3,0 8 Y 77 S'8 4c) <br /> by the following named persons: <br /> FULL NAME RESIDENCE <br /> i2 JC.t£. 6, 12r, /6 / Ser, 5 +- I7WIC4 910 r rTtslrPrE <br /> Home Phone: 5-06 417;, qsy o <br /> Wertify under the penalties of perjury that I, to the best of my knowledge and belief,have filed all state tax returns and paid all state <br /> axes as required under law. <br /> *Signature of individual By: Corporate Officer <br /> **Social Security Number(Voluntary) <br /> or Federal Identification Number <br /> *This license will not be issued unless this certification is signed by applicant <br /> **Your social security number will be furnished to the Massachusetts Department of Revenue to determine whether you have met tax filing or tax <br /> payment obligations. Licensees who fail to correct their non-filing or delinquency will be subject to license suspension or revocation. This request <br /> is made under the authority of Massachusetts General Law,Chapter 62C,Section 49A. <br /> The Commonwealth of Massachusetts <br /> BARNSTABLE ss DATE <br /> Personally appeared before me the below namedand made oath that the foregoing statement is <br /> true. <br /> A certificate issued in accordance with this section shall be in force and effect for four years from the date of issue and shall be renewed <br /> each four years thereafter so long as such business shall be conducted and shall lapse and be void unless so renewed. <br /> Signed. <br /> Notary c <br /> 'SEAL <br /> r• - ommissio l Expires: <br />