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BUSINESS CERTIFICATE#05�/ <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> TOWN OFMASHPEE <br /> • DATE [ oZ 9 I og <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 herebyydeclare(s)that a business under the title of <br /> - Rovtda CdoLAeH DBA 'i1.Q GoIdP�_ �'a+✓ is conducted at <br /> Business Location: oZ a Fa I wtovfl. Qoa d U..:} `(A' Aasti vP , dA • oa 644 <br /> Business Mailing Address: / <br /> Business Type: 00q Gfoorw-�bvo Business Telephone: <br /> by the following named persons: <br /> FULL NAME RESIDENCE a . <br /> Rm-Ala C%0JeK 15, Ard&„ 2wd m. oaO? <br /> Home Phone: 5w9'39Y-C 79 <br /> �eertify 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 /> s as required under law. <br /> *Signature of individual By: Corporate Officer <br /> 09Iy- (4R gala <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 ojMassachusetts if n� <br /> BARNSTABLE ss DATE O W <br /> Personally appeared before me the below named I l JrA C Y 0 iAJ/Z and 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. r <br /> k <br /> Signed <br /> r <br /> • M:1RI1.\ 1-SCU1..1, ryPu`. <br /> SEAL \otv. Public <br /> o(�assachuseCommomUsMay-': Y3 :20 <br /> 6(" <br /> Mc Cmnmission Expires Commission Expires: <br /> \larch 31.2006 <br />