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-ti <br /> BUSINESS CERTIFICATE# 10-0 It <br /> THE COMMONWEALTH OF MASSA CAUSETTS <br /> • TOIVN OF MASHPEE <br /> DATE 12 -11 - 0 -9 <br /> Expiration Date: December 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 <br /> CAFC— COD CC-(Nll &q INC* DBA �AG1165 FV B is conducted at <br /> Business Location: IOD GREAT N Ee\C 2oA 0 NO j2 l tl� M ASH PEf N f) 626Zf',9 <br /> Business Mailing Address: QQC R �Pr l N &0 < V�U/9 D (VCU Q T 0 , ptA S H YFE \`m hi O z6 `�9 <br /> Business Type: ZEST \�9__ Business Telephone: 5OP — -7 _ \ /O 0 <br /> Home Phone: 509- 477 - b0O Q <br /> by the following named persons: <br /> FULL NAME RESIDENCE <br /> Rk12HW12 ) E, WA\,) N0?TN, MASHPff W oZ6Q9 <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 /> fes as requ' ed unde w. <br /> *Signature of authorized agent *Signature of authorized agent <br /> i o4 ^ z `] p z zV + <br /> **Social Security Number(Voluntary) <br /> or Federal Identification Number <br /> In case of emergency Q d q <br /> NAME: R\(_HARO ►�-P�RAI TELEPHONE NUMBER: JcO(/- 17�- /OU <br /> Alarm Company: INT4Zd0Y Ak-A M r <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 /> BAIL\'STABLE ss <br /> The Catnutomvealth of Massachusetts <br /> ;� - DATE <br /> Personally appeared before me the above-named "tC_w�p-et y7 �'`�K-t(�i��� and made oath that the foregoing statement is <br /> true. <br /> Ayae 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 (our ars Ther after so Rnas uch business shall be conducted and shall lapse and be void unless so renewed. <br /> gned <br /> 0 <br /> P1t®6}1CLLI,JR <br /> SEAL LrCOOMMOZNWEALTH <br /> otary RIDuc <br /> OF tMBSgeHUSE <br /> es: <br />