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BUSINESS CERTIFICATE#063 <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> TOWN OF MASHPEE <br /> DATE <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 declare(s) that a business under the title of <br /> EDMAR IF- PP AoT E DBA SAo9 j W_c-a�(J N is conducted at <br /> Business Location: 32 !�QJNLL :DR MASHPEe MA U2lA4g <br /> Business Mailing Address: SAME <br /> Business Type:Cnmm(RCiAL— 1 FQ 11 Business Telephone: 7MH — 636— 6001 <br /> by the following named persons: <br /> FULL NAME RESIDENCE <br /> P_-bLAArz F RRn,N—r SA�1E <br /> Home Phone:—SC)S— L477--79177 .. - <br /> I certify under the penalties of perj that I, to the best of my knowledge and belief, have filed all state tax returns and paid all state <br /> taxes as required under law. <br /> 'RWignature of authorized agent *Signature of authorized agent <br /> 017 - 8(n— y245 <br /> **Social Security Number(Voluntary) <br /> or Federal Identification Number <br /> In case of emergency —7p <br /> NAME: 'RCl_S 1 LE NE- TELEPHONE 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 sub meet 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 {^ nR +T DATE 3 Q <br /> Personally appeared before me the above-named E_►_ M A K rF PAN t F 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 yearsthereafterso long as such business shall be conducted and shall lapse and be void unless so renewed. <br /> Signed �iA/yy�//+n <br /> • `c SER;L Notary P is <br /> 1 Deborah F. Dami <br /> o NOTARY PUBLIC Commission Expires: <br /> Commonwealth of Massachusetts <br /> My Commission Expires July 24,2009 <br />