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* BUSINESS CERTIFICATE#09 <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> TOIUNOFMASHPEE <br /> DATE <br /> i <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 /> 'At ,,I �J - <br /> i C4o �As ���^O [54 DBA A/CCk.,S (pt'Nt—t"1' �- is conducted at <br /> Business Location: NI�J /JC�LG"f�Rs 6'/P}- U <br /> � <br /> Business Mailing Address: 11 nQ Bx 100 fidrf S I At_ M )� <br /> Business Type: CAMS(( a Business Telephone: <br /> by the following named persons: <br /> FULL NAME R-SIDENC <br /> AldketRSG�aN�a <br /> Home Phone: ` 7 -7 > <br /> I certify under the penalties of perjury that 1, to the best of my knowledge'and belief, have filed all state tax returns and paid all state <br /> taxes as required gwiSr law. _ <br /> rature of authorized agent *Signature of authorized agent <br /> a to- .a^00 / <br /> **Social Security Number(Voluntary) <br /> or Federal Identification Number - <br /> In case of emergency <br /> NAME: /Vti��LCOS 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 suspension or revocation. This request <br /> is madeunder the authority of Massachusetts General Law,Chapter 62C,Section 49A. <br /> The Commonwealth 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 />