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2004
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2004
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Last modified
12/1/2016 8:56:20 PM
Creation date
11/13/2016 10:16:15 PM
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Box 037
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TOWN OF MASHPEE <br /> • Statement of Discontinuance,Change of Residence,Change of Location of Business, <br /> Withdrawal,or Deceased from Business or Partnership,Change of Business Name or Owner Name <br /> TE <br /> In conformity with the provisions of Chapter one hundred and ten; section five, of the General <br /> Laws, as amended,the undersigned hereby clare(s)thatyWe has (have)) this day discontinue (retired <br /> from) (withdra from the business of., ...T .. xl/Q ...,... <br /> J , <br /> conducted at . <br /> STREET <br /> In the Town of Mashpee. <br /> ...�ir.? 'g'rlal.Ale .. .. .... <br /> SIGNATURE <br /> I hereby state that the location of the business/my residence as it appears on the Business <br /> Certificate filed on '..DT LM ..:.............has been changed to .................................. <br /> ............................................................ <br /> SIGNATURE <br /> • I hereby state that the name of the business or the owner as it appears on the Business Certificate <br /> has been changed <br /> from.....``5.'+-V-.VVIk..................................................................................... <br /> to................._v ........,..... . . `.....I .......... <br /> tom. /rte/ .. .... `L....Ia .Q .. <br /> SIGNATURE DATE <br /> •%/��/•....55. jy�.... �L.l.•n..1�/. li/ ........... <br /> Personally appeared before me the above na ted./.!.//(.! S�tr.. Ll /l.%...and made <br /> oath that the foregoing statements are true. <br /> ..4uk <br /> ... .... ...�. � ... .. . .. ....... <br /> - ...1.��... ..TI ..:::. .�� .............. <br /> Commission Expires <br /> O <br /> Otigfommiscontinuwce <br /> .... .. . . .. ... <br />
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