Laserfiche WebLink
BUS II SS CERTIFICATE#07_y� <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> TOWN OF MASHPEE O - <br /> DATE <br /> • 07 <br /> Expiration Date: December 31, 2011 <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 /> �Xs7CiSCa 42 ' I DBA is conducted at <br /> Business Location: <br /> Business Mailing Address: / 2 IROS ctuef hIeVI MSS-gpee 'M'6Business Type: L Ard Apf PCL V I Nom_ Business Telephone: s(OT{ - R$'W - <br /> by the following named persons: <br /> F LL t ME RESIDENCE le riP <br /> [ pA <br /> /2A54f�?e M iq Pz4'4�j <br /> Home Phone: <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 /> taxes as required under law. <br /> C <br /> Mkgn Lure of tied agent * nature of a prized agent <br /> **Social Security Number(Voluntary) <br /> or Federal Identification Number <br /> In case of emergency <br /> NAME: 4 iX ekln C41 rd o TELEPHONE NUMBER: 50 <br /> Alarm Company: <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 C) <br /> //1' \ DATE a . P0- -)C '7 <br /> ('�t 1 <br /> Personally appeared before me the above-named Qa - Cor-r- ?a 9Z 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 thereafterso togas such business shall be conducted and shall (apse and be void unless so renewed. . <br /> Signed -� <br /> • otaryPublic <br /> SEAL OIOl'bZ 7dag satldx3 u0lsslwwo0 6(n 0 <br /> Margaret C. SantosloesseW to glleaMuowwo0 3 (- <br /> o NOTARY PUBLIC DllBfld k8ViON Commission Expires: <br /> Commonwealth ofMassach®etls,eg C ;ade6jeVq z <br /> 'Ay Commission Expires Sept.2M4.1010 <br />