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BUSINESS CERTIFICATE#09 Of`7 <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> TOWN OF MASHPEE <br /> DATE (pLOq <br /> Expiration Date: December 31,.2013 <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 q �aV. L CUI )Pn be conducted at <br /> 1p (Ydbe-ld. P LG Mashpee NA oz&yIg? I <br /> Business Location: �/ /+ �, / n ` � /-', <br /> Business Mailing Address: � b Lshe/�11e,/dL place tdi�7/—Iq razz-& 9 <br /> Business Type: ��Gfr l.�-a.C. Business Telephone: S0$1 y77 7810 <br /> Smczr► Svfr 34ao 033Z <br /> by the following named persons: <br /> FU1 <br /> 4 <br /> A7 <br /> I44aa <br /> � r r � <br /> Home Phone: 7oD � Yi7/Lsr - <br /> I certif 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- --. - <br /> es as quired under la <br /> kwrrLt <br /> !rgn hue of aut onzed gent / *Signature of authorized agent <br /> **Social Security Number(Voluntary) <br /> or Federal Identi&cation Number <br /> In case of emergency <br /> NAME: 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 Massachusetts Department of Revenue to determine whether you have met tax filing or tax <br /> payment obligations. Licensees who fail to correct their non-filing or delinquency will be subject to license susnension or revocation. This request <br /> is made under the authority of Massachusetts General Law, Chapter 62C,Section 49A. <br /> The Conunonowalth of Massachusetts <br /> BARNSTABLE ss DATE <br /> Personally appeared before me the above-named and made oath that the foregoing statement is <br /> true. <br /> 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 <br /> each four years thereafter so long as such business shall be conducted and shall lapse and be void unless so renewed. <br /> Signed <br /> • Notary Public <br /> SEAL <br /> Commission Expires: <br />