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2006
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11/17/2016 3:10:00 PM
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11/13/2016 10:16:22 PM
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Box 037
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7 <br /> BUSINESS CERTIFICATE#06-161 <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> • TOWN OFMASHPEE Ila S-A b j, <br /> Expiration Date: December 31, 2010 <br /> In conformity with the provisions of Chapter one hundred and ten, Section five of the General Laws, as amended, the <br /> undersigned hereby deciare(s)that a business under the title of <br /> j�cSW'�✓! �/ 4- Son <br /> Home = �� DBA L�an r P M CS w�pney S is conducted at <br /> Business Location: / 114y yid f('e' t 44a Sallee W4 Oa6 q Q <br /> Business Mailing Address: 5-4 rrt e <br /> Business Type`. }16-.vte ,, en Business Telephone: S 3 <br /> by the following named persons: <br /> FULL NAME - RESIDENCE <br /> /Jan iG C° �SW ePyley SYL - f /{'[aci/7C �%Cr <br /> Z"- <br /> Home <br /> NHome Phone: 5 3 1 —/O 6a <br /> I certify 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 /> es as required under 1 <br /> a <br /> ignature o authorized agent _ *Signature of authorized agent <br /> / 3ysvy�s � <br /> **Social Security Number(Voluntary) <br /> or Federal Identification Number <br /> In case of emergency <br /> NAME: TELEPHONE NUMBER:3 0& — 3 J-,? S J`b a <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 DAT pOb <br /> Personally appeared before me the above-named ltt,n: t:\ f •CS(s.-e.Eh a�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 suc isiness shall be conducted and shall lapse and be void unless so renewed. <br /> Signe <br /> i "I <br /> • <br /> 6� My <br /> Margaret C: Santos otary Pu rc <br /> SEAL NOTARY PUBLICCommonwealth of Massachusetts ql - a 4 - 7G 16 <br /> Commission'Expires Sept.24,2010 Commission Expires: <br />
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