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BUSINESS CERTIFICATE# 1 o- 6.7 <br /> THE COMMON6VEAL TH OF MASSA CAUSETTS <br /> ' TOIVN OF MASHPEE nn <br /> DATE �.�'I I — U-I <br /> Expiration Date: December 31, 2014 <br /> In confomvty 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 /> I- k4 A �16 n ,AII ��AA DBA trY 4 SoAbr) is conducted at <br /> Business Location: 51 'uQ 7n F- 1115 Wwa'�4 Md.Pik .un <br /> Business Mailing Address: I A.Y' cu, E I I I$ Yt w 0 <br /> Business Type: OM h � usiness-,re, <br /> lephone: <br /> Home Phone: J �I <br /> by the following named persons: <br /> FULL NAME RESIDENCE <br /> Wa,n qi 6Ad& A_ 4 C- Fa rnpu4i mR - 05,,53(o <br /> Shauna-- Gi)(150 IN/ g Animij Sriti Fnrts]LWe MA- - <br /> I certify 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 /> res as required under law. <br /> W:� l <br /> 'wSignature of aut#rized agent *Signature of authorized agent <br /> **Social Security Number(Voluntary) <br /> or Federal Identification Number <br /> In case of emergency ^n <br /> NAME: 61 1 Ial yra^. 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 subiect 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 /> BAIL\STABLE ss / � DATE /L�q <br /> Personally appeared before me the above-named / �T k L Wt I�}•A,/ 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 /> gned DD <br /> c <br /> SEAL CONYOWMTH OF <br /> my Carnmiaeian <br />