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Nyi BUSINESS CERTIFICATE# ` kfY/Q ^O <br /> THE COAP.1110MVEALTH OF MASSACHUSETT S <br /> TOIViV OF HASHPEE <br /> DA"CC- <br /> . Expiration Dale: .? / <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 and r the title of - <br /> Business Nanle/DBA: Corporation Name:/yJgC' S �$ . L✓/�f T/G is conducted at <br /> Business Location: / S n t� <br /> qj <br /> Business 14ailing Address: 7�/-) 'q41`ez'+ �� 66 X .2V) 7 <br /> BusinessType.60410Q A./1_ &ks SSaJ/C/I- Business'l'elephone: 77 o?1 "3G2r <br /> Home Phone: 50- 4 .02 Email Address: Q GtPvNI/.LC' . L-i7 Kim <br /> by the following named persons: ✓7 1 <br /> Owner 'an J/ 071ru 11 c� <br /> T 2— <br /> [ certify unthe penalties of per try that 1, to the best of my knowledge and belief, have filed all state tax returns and paid all state <br /> taxes as re d under law. <br /> zll/ <br /> ',,nature o uthorized agent **Social Security Number(Voluntary) <br /> or Federal Identification Number <br /> *This license will not be issued unless this certification is signed by applicant <br /> In case of emergency <br /> NAA\4E: TELEPHONE NUMBER: <br /> Alarm Company: <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 ofAfrssachusetts <br /> B:UtNSTABLE ss DATE V fI <br /> 1 ` <br /> Personally appeared before me the above-named t6 oke a, �, <br /> 1T= and made oath that the foregoing statement is <br /> [rue. <br /> A cenifica is ued 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 Cher aft so to as such i ess shall be conducted and shall lapse and be void unless so renewed. <br /> Signed <br /> Notary Public <br /> • SEAL <br /> � JOSFPNt uu <br /> n� Co11wykFipq Vxpues:WS ' <br /> COMMONWFAl7N OF SACNUBfT <br /> MYCartimssionbom <br /> 1 <br />