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BUSINESS CERTIFICATE 9 q— <br /> THE COMAIONIVEALTH OF MASSACHUSETTS <br /> TOWN OF MASHPEE / <br /> DATE <br /> • Expiration <br /> ''Date: �r <br /> In conformity with the provisions of Chapter one hundred and ten, Section five of the General Laws, as amended, the <br /> unclersigned hereby declare(s) that a business under the title of <br /> i + , A <br /> Business Nanie/DBA: orporation Name: is conducted at <br /> Business Location: Ll it <br /> Business Dlailing Address: 2�2 A _ <br /> Business Type: 'vQt.( Y �f1-X O P,1 Business Telephone: ,� – 4�7-7-a seo <br /> Home Phone: Email Address: <br /> by the following named persons: <br /> Owner Name Owner Residence <br /> �fftAzl 1 I EN ), i n o g:, _�"D7) <br /> I certify under the penalties of perjury that 1, to the best of my knowledge and belief, have filed all state tax returns and paid all state <br /> required under law. <br /> 2 77_ 0 � _ 92sQ <br /> nature of auith6rized agent "Social Security Numder(Vo untary) <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 /> (NANIE: Thy TELEPHONE NUMBER: <br /> i <br /> Alarm Company: <br /> **Your social security number will be famished 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 ofKassachusetts G /O <br /> BAIL\'STABLE ss . DAT y vLQ <br /> Personally appeared before me the above-named Tit'/V 'SON b D i a—'1 nd made oath that the forts ing statement is <br /> true. / , <br /> A certificate issued in a rdance 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 ong as site business shall be conducted and shall lapse and be void unless so renewed. <br /> 1 <br /> Signed <br /> � � t <br /> otary blit <br /> • SEAL - <br /> DAOrsh " Commission Expires: <br /> EQMNd <br />