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BUSINESS CERTIFICATE#Qj—�2 <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> TOWN OF MASHPEE /_� <br /> DATE 1Ci7 CbL?---7-1 — <br /> Expiration Date: December .31, 20IL_ <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 /> DBA /mil <br /> is conducted at <br /> Business Location: <br /> Business Mailing Address: ii/I ,J��7���— <br /> Business Type: y'-7/Business Telephone: ("/U/ —! Oel - <br /> by the following named persons: <br /> NCE <br /> 1–c/ LL N �� J <br /> 7 L7G/'l� <br /> Home Phone: <br /> I certify under the penalties of perjury that h 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 /> Adak <br /> ignamre of authorized a_en[ *Signature of authorized agent <br /> "Social Security Number(Voluntary) - <br /> or Federal Identification Number <br /> In case of emergency <br /> NAME: TELEPHONENUMBER <br /> Alarm Company: <br /> *This license will not be issued unless this certification is signed by applicant <br /> I <br /> "Your social security number will be famished to the Nfassachusetts Department of Revenue to determine whether you have met tax tiling or taA <br /> payment obligations. Licensees who fail to correct their non-filing or delinquency will be subject to licence suspension or re ocation. This requesi <br /> is made under the authority of Massachusetts General Law Chapter 4 9 <br /> p G_C. Section 1)A. <br /> The Commonwealth of Massachusetts A p <br /> BARNST-xBLE as DATE <br /> Personally appeared before me the above-named (r\.d6)P orc,n I I and made oath that the foregoing statement is <br /> true. <br /> A certificate issued in accordance with this section shat! a in force and effect for four years from the date of issue and shall be renewed <br /> each four years th r after so ng ass h b i ess shall be cond t and shall lapse and be void unless so renewed. �-- <br /> Signed <br /> • SEAL - Notary c <br /> Q Margaret C. Santos aj�2U-90�1� <br /> NOTARY PUBLIC <br /> Commonwealth of Massachusetts Commission Expires: <br /> Ny Commission Expires Sept.24,2010 <br />