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2008
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Last modified
11/11/2017 3:50:23 AM
Creation date
11/13/2016 10:16:27 PM
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Box 037
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• BUSINESS CERTIFICATE#08 IV <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> • TO PVN OF MASHPEE <br /> DATE <br /> Expiration Date: December 31, 2012 <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 /> ¢�DBAC APC5IA Mkk�°-�— Glk� l'�iyrj� � s (conducted at <br /> Business Location: W l SC't — /J�• �iJ Q-2- N"t�'7 .— 02L/{rJ // <br /> Business Mailing Address: 14S�(!G� ��� • p - �L�./p <br /> Business Type: Se'V lCR Business Telephone: <br /> by the following named persons: <br /> 1 kt E7ID NCESum �- <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 /> as required Linder law. <br /> 'S�ianue of authoriz d ent *Signature of authorized agent <br /> 01L( - 5(o -'Ko I-i 1 <br /> **Social Security Number(Voluntary) <br /> or Federal Identification Number <br /> � , In case of emergency 2p.'} <br /> NAME: 3 ^12yA-&� > • V"/� TELEPHONE NUMBER: N� <br /> .Alarm Company: <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 DATE / Jju <br /> Personally appeared before me the above-named .1/ R=Q2 and made oath that the foregoing statement is <br /> a � � <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 - s thereafter so long as such business shall be conducted and shall lapse and be void unless so r ewed. <br /> Signed <br /> SEAL J SEPtPublic jJR <br />
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