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SA <br /> BUSINESS CERTIFICATE# 10- d Qt <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> • TOWN OF MASHPEE '���/� 16g DATE _�J�I <br /> Fxpiratinn Dare- Deaanthi r 31, 2014 <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 �j� <br /> �Ue� �A►ZK�12 DBA Au. 5fii a /5 is conducted at <br /> Business Location: /✓ <br /> razlw Business Mailing Address: rr I A /j,O K l * by <br /> Business Type:C� fL /ps�7�E} Business Telephone: <br /> Home Phone: <br /> by the following named persons: <br /> UL / <br /> UGG N L� L(7� /f �f SfPE �lJ/1�/ /� <br /> I certify under the peri s o perjury that I, to the best of my Imowledge and belief, have filed all state tax returns and paid all state <br /> Axes require and W. <br /> !tel-✓ <br /> *Signature of AAithorized agent *Signature of authorized agent <br /> J40NAft 3 JA za <br /> **Social Security Number(Voluntary) <br /> or Federal Identification Number <br /> /� Inn case ofeperg n <br /> NAME: 0 _ �L_ (7 t VEWTELEPHONE 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 made under the authority of Massachusetts General Law,Chapter 62C,Section 49A. <br /> The Commonwealth of Massachusetts ' <br /> BARt\'STABLE ss DATE <br /> Personally appeared before me the above-named PWC F; 1'' ' IC and made oath that the foregoing statement is <br /> true. <br /> A certificate issued in ac rdance 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 t reaftersgIon such business shall be conducted and shall lapse and be void unless so renewed. <br /> Signed L <br /> • JtJ JqGIEPH11JR <br /> SEAL No�ry PuE6c <br /> COMYONWFALTH Of MA99ItpItNETTj <br /> 7SWROMpires: <br />