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<t%town <br /> :G:::;fir• _ _ <br /> TOWN OF NLA SBPEE <br /> ..,�Vit. <br /> snOLE co.. <br /> Statement of Discontinuance,Change of Residence, Change of Location of Business, <br /> Withdrawal,or Deceased from Business or Partnership,Change of Business Name or Owner Name <br /> ,6A!�ja /tel <br /> V DA <br /> Discontinuance - <br /> In conformity with the provisions of Chapter one hundred and ten, section five, of the General <br /> Laws, as amended, the undersigned hereby d are(s) that a has (h ve) this day discontinued (retired <br /> from)(withdrawn from)the business of <br /> conducted at <br /> STREET <br /> � `ClllttitP�w ��o <br /> 'SIGNATURE <br /> Change of Locati of Business <br /> I hereby state that the location of the business/my residence as it appears on the Business Certificate filed <br /> on / /J}`C WCC 2 zal" �as been changed to <br /> /Name of usiness V <br /> G��lz <br /> SIGNATURE - <br /> Change of Name of Business or Owner <br /> I hereby state that the name of the business or the owner as it appears on the Business Certificate has <br /> been changed from <br /> to <br /> SIGNATURE <br /> Notary <br /> Barnstable ss. -/ <br /> Date <br /> Personally appeared before me the above named ixC /50 n made oath <br /> that the foregoing statements are true. /1 <br /> . Deborah F. Dami .Notary Public <br /> NOTARY PUBLIC <br /> Commonwealth of Massachusetts Commission Expires <br /> WOrigfotia/Discontlnuance My Commission Expires July 24,2009 . <br />