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BUSINESS CERTIFICATE#08-)�/ THE COMMONWEALTH OF MASSACHUSETTS • TOWN OF MASHPEE DATE a -afr'-<3p- Expiration Date: December 31; 2012 In conformity with the provisions of Chapter one hundred and ten, Section five of the General Laws, as amended, the undersigned //hereby declare(s) that a business under the title of� �n ' I %,( "N6o� DBA M(A T '�S�)JQ S 0�-- l(.�1yl�yy,is conducted at Business Location: tJC / �1?-�IC�Gt. / i L Business Mailing Address: Sx.t/ 7 iz Business Type: ' -p— l nip Business Telephone:— by the following named persons: FULLY1aS4�2Cxry_ a Q� Home Phone: 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- Des as required under law. *Signature of authorized agent *Signature of authorized agent **Social Security Number(Voluntary) or Federal Identification Number In case of emergency NAME: TELEPHONE NUMBER: Alarm Company: *This license will not be issued unless this certification is signed by applicant *"four social security number will be famished to the Massachusetts Department of Revenue to determine whether you have met tax filing or tax payment obligations. Licensees who fail to correct their non-filing or delinquency will be subiect to license suspension or revocation. This request is made under the authority of Massachusetts General Law,Chapter 62C,Section 49A. The Commonwealth of Massaehasetts BARINSTABLE ss DATE Personally appeared before me the above-named and made oath that the foregoing statement is. true. . 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 each four years thereafter so long as such business shall be conducted and shall lapse and be void unless so renewed. Si_ned • Notary Public SEAL Commission Expires: