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2008
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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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BoxNumber
Box 037
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IV Own <br /> v e• � 2 <br /> ri _�,$• / <br /> TOWN OFMASHPEE <br /> '�Tlil,r,GV" <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 /> \Q t I O� <br /> DA E <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 hereb declare(s that I/We has (have) this day discontinued (retired <br /> from) (withdrawn from)the business of a L a� are 4ary C-e_ <br /> conducted at �l A°'MPatt r, <br /> STREET ` <br /> SIGNATURE <br /> Change of Location of Business <br /> I hereby state that the location of the business/my residence as it appears on the Business Certificate filed <br /> • on has been changed to <br /> Name of Business <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 and made oath <br /> that the foregoing statements are true. <br /> g g <br /> • <br /> Name-Notary Public <br /> Commission Expires <br /> On g form/Discontin u ance <br />
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