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BUSINESS CERTIFICATE#09 a �� <br /> • THE COMMONWEALTH OF MASSACHUSETTS <br /> TOWN OF MASHPEE <br /> DATE <br /> 02010 <br /> Expiration Date: December 31, <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 [ / �t <br /> k 1 AlijPI/7 �lt�Rrl/i?4JGft/!C'CS is conducted at <br /> Business Location: ��9 l y2C 4 ! ,/(/(SCh /?A4c/ (I T/ MAs4 ee /M 0 dp 47 <br /> Business Mailing Address: J?QAy 'TNI 1"7,#SLjdz�r M1 /per'6?6 <br /> Business Type: Business Telephone: <br /> by the following named persons: <br /> FULL NAME RESIDENCE �, <br /> /1�.4ovni Jai/rP �.doGZ /.3Y l'��-t /1/ce%� lC9P /1�0 <br /> Home Phone: <br /> W <br /> ertify 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 law. <br /> *Signature of authorized agent *Signature of authorized agent <br /> )/-? - lo / 7003 <br /> **Social Security Number(Voluntary) <br /> or Federal Identification Number <br /> In case of emergency <br /> NAME: TELEPHONE NUMBER: <br /> *This license will not be issued unless this certification is signed by applicant <br /> **Your social security number will be famished 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 D E o� �'1'i <br /> y� i <br /> Personally appeared before me the above-named / I Orki r 1 GyCe 4 t)je2Z and made oath that the foregoing statement is <br /> true. i <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 there r so long as such business shall be conducted and shall lapse and be void unless so renewed. <br /> Signed <br /> • Q Margaret C. Sant otary Public <br /> SEAL !� NOTARYPUBUC <br /> 1 Commonwealth of Mambusells' <br /> NY Commission Expires Sept.24,20 Commission Expires: <br />