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00 <br /> TOWN OF MASHPEE <br /> ./" Statement of Discontinuance, Change of Residence, Change of Location of Business, <br /> Irawal,or Deceased from Business or Partnership, Change of Busine s Nan or Owner Name <br /> DA E <br /> The Town is desirous of going"Green" as much as possible.T1}o.that end, please include your email address. <br /> Email Address: <br /> 1 Discontinuance <br /> In conformity with the provisions of Chapter one hundred and ten, section five, of the General <br /> Laws, as amended, the undersigned herebylJe lare(s) that UW s h ) t i� y discontinued (retired <br /> from) (withdrawn from) the business of <br /> conducted at <br /> STREET <br /> c <br /> SIGNATURE <br /> Cl V1S QivQ�\w1 llY1\--� Lo <br /> Change of Location of Business <br /> I hereby state that the location <br /> noof•the business/my residence as it appears on the Business Certificate filed <br /> on Q I I a�Da , has been changed to <br /> Name 4umes <br /> ni f\.< <br /> IGNATURE <br /> GQ r�i c\—O <br /> ChJnge 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 l��I 1 l X12 <br /> to L V 2. <br /> SIGNATURE <br /> Notary <br /> Barnstable ss. <br /> Date <br /> Personally appeared before me the above named <br /> �L 1/r C and made oath <br /> that the foregoing statements are true. <br /> • Nne-64D.ta�QMJ L:MAZVJCCNEtU A <br /> e Notary Pttk <br /> C i THi TH OFF <br /> pBaper 2S,2013 <br /> OrigfomVDiscontinuance 2. <br />