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�3 20 /o ao�� <br /> BUSINESS CERTIFICATE# <br /> • THE COMMONWEALTH OF MASSACHUSETTS (7 CQ <br /> TOWN OF MASHPEE <br /> DATE 7/1/10 <br /> Expiration Date: 3 _ <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 /> Walgreen Eastern Co., Inc. DBA Walgreens #13135 is conducted at <br /> Business Location: 21 South Street Mashpee MA 02649-6501 <br /> Business Mailing Address: PO Box 901, Deerfield, IL 60015 <br /> Business Type: Retail Drug Store Business Telephone: 508/477-0137 <br /> Home Phone: <br /> by the following named persons: <br /> FULLNAME RESIDENCE <br /> Margarita Kellen 845 Wagner Rd., Glenview IL 60025 <br /> Gary Martin 1309 Madison Buffalo Grove, IL 60089 <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 /> taxes as required under law. <br /> *Signature of authori ed agent Margarita Kellen,Vice President *Signature of authorized agent Gary Martin,Assistant Treasurer <br /> 36-1924026 <br /> **Social Security Number(Voluntary) <br /> or Federal Identification Number - <br /> In case or emergency <br /> NAME: Alarm Monitoring & Installer Company TELEPHONE NUMBER: 800/695-9904 <br /> Alarm Company Walgreen Company Central Station <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 /> Tire Commonwealth of Massachusetts <br /> BARNSTABLE ss - ` DAT �� <br /> Personally appeared before me the above-named a AIJ IS FL-PLA&A 0J and made oath tha a fore oing 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 /> fl <br /> �{wpj �rA� Notary Pu is <br /> SEALwMallin son w <br /> J*2k 201A Commission Expires: <br />