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Last modified
11/17/2016 3:11:02 PM
Creation date
11/13/2016 10:16:34 PM
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Box 038
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.A,. <br /> BUSINESS CERTIFICATE# Z0Jt O —0 /J-6 <br /> THE COMfYtONFVEALTH OF MASSACHUSETTS <br /> TOMN OF MASMEE DATE 6 <br /> • Expiration Date: 3 z I <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 /> Business Name/DBA: 14� ,- ZX 6t.& Ca/--. Corporation Name: 49=,3 Af70 is conducted at <br /> Business Location: S r- <br /> Business Mailing A(Idress: e.4 . &2A MA--4�JLO 4 0 2 <br /> Business Type: "�E Yj4� toC�E �O.�.--( Business Telephone.J� �- Sd 7 - 19 9� <br /> vcwzdz CA ,e ,o- Cy- <br /> Home Phone: � e - :1.39 - O 79 Email Address: Ol CP(E� YE�izo <br /> by the following named persons: <br /> Owner Name Owner Residence <br /> -:Jr-, <br /> F-04-f-7—G) <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 /> taxes as required under law. <br /> Dai3� 7370 <br /> ,n tee of authorized agent **Social Security Ntmaber(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 /> TELEPHONE NUMBER: <br /> NAME: <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 /> 9 The Commonwealth ofAlassachusetts <br /> BARNSTABLE ss v r� DATE d ZQ <br /> Personally appeared before me the above-named Q A A) Vi 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 there fter so I as such business shall be conducted and shall lapse and be void unless so renewed. <br /> Signed <br /> Notary Public <br /> • SEAL JOSEPH L.MAGI{ MUM <br /> e� COMMON Ex fres: <br /> Oda0Yt26.20t9 <br />
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