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4�t\f,.anWIV,OF4, y _ <br /> yj cy.�a l TOWN OF MASHPEE <br /> Statement of Discontinuance,Change of Residence,Change of Location of Business, <br /> �nuti;;co`'s Irawal,or Deceased from Business or Partnership,Change of Busilriess Name or Owner Name <br /> D TE <br /> The Town is desirous of going"Green" as much as possible. To that end, please include your email address. <br /> Email Address: <br /> Discontinuance <br /> In conformity with the provisions of Chapter one hundred and ten, section five, of the General <br /> Laws as amended the undersigned hereby declares that Me has (have) this day discontinued retired <br /> g Y O <br /> from)(withdrawn from)the business of � C;,WARE! TpG�� �ODL <br /> conducted at ��l <br /> STREET <br /> SI ATURE <br /> Change of Location of Business <br /> I hereby state that the location of the business/my residence as it appears on the Business Certificate filed <br /> on has been changed to <br /> • Name of Business <br /> SIGNATURE <br /> Change of Name of Business or Owner <br /> I hereby state that the name of the business or the owner as it appears on the Business Certificate has <br /> been changed from <br /> to <br /> SIGNATURE <br /> Notary <br /> Barnstable 5s. <br /> Date <br /> Personally appeared before me the above named and made oath <br /> that the foregoing statements are true. <br /> • Name-Notary Public <br /> Commission Expires <br /> ongform/Disconti nuance <br />