Laserfiche WebLink
BUSINESS CERTIFICATE#0$L-a <br /> l; <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> TOWN OF MASHPEE <br /> DATE <br /> • Expiration Date: December 31, 2017, <br /> Inconfornucy with the provisions of Chapter one hundred and ten, Section five of the General Laws, as amended, the <br /> undersigned hereby declare(s)/th�at a business under the title of <br /> DBA p�^ <br /> — --� / / ,-/� r is conducted at <br /> Business Location: �� �� J�Al�C LL//t ��( ✓� ` C <br /> Business Mailing Address: �A4V`ck- ' <br /> Business Type:. 9 ', / S lvf,:BTusiness Telephone: SU.� - 2 -917 <br /> by the followin named persons: <br /> II l �Q <br /> FULL Nn <br /> 1 J <br /> Home Phone:52's-- -9r 7`f' <br /> I cerdfv 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 /> tgnature of authorized agent *Signature of authorized agent <br /> "Social Security .,umber(Voluntary) <br /> or Federal Identification Number -In case of emergency <br /> NA:NfE: TELEPHONE NUMBER: <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 :Massachuserts Department of Revenue to determine whether you have met tax tiling or tax <br /> paymemt obligations. Licensees who fail to correct their non-tiling 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 /> BARNSTA,BLE ss �. DATE <br /> Personally appeared before me the above-named_.. L\�Nft.`.� \x\ ,I�C]. and made oath that the foregoing statement is <br /> true. <br /> A certificate issued in accordancewith this section shall be in force and effect for four years from the date of issue and shall be renewed <br /> each four years thereafter so long assuch busine shall be conducted and shall lapse and be void unless so renewed. - <br /> Signed <br /> • SEAL Notary Public <br /> Coor.i <br /> COMMONWEALTH OFY11 MAUbISSACHU8ETi8 <br /> My COlnnllssion Expires <br /> July 19,2013 <br />