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2011
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Last modified
11/17/2016 3:11:02 PM
Creation date
11/13/2016 10:16:35 PM
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Box 038
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-Trr- r <br /> BUSINESS CERTIFICATE fF��>�� <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> • T06,7V OF MASHPEE <br /> DATE <br /> Expiration Date:. 'Z' Ddu a2 D/ <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 business under the title of <br /> C —j^I — I h/API ( I is conducted at, <br /> Bpsiness'N;ime/DBA': r';,VATnen ILVA(lAwkiC�JorrporationName: C% TyF`(' � r-7�-7 <br /> Business Location: b U`7a ad. RCCA N � ad , n) r /n)U r <br /> Business Mailing Address: <br />! Business.Type:�J(.Q_ fV1Vl1�� BusinessTelephone:�ue <br /> AomeYhonA; Email Address: KC(B I(U (CAV[x 1 Y/;( IIA�t <br /> by the following named persons: <br /> nf� Owner Name Owner Residence <br /> I /('IY1sr� Vrlvm "�hnNwx�6iAu�— <br /> I certify under the enalti of pe"'� t the best of my knowledge and belief,have filed.all state tax returnspgd.paid allstate <br /> taxes asgreunder <br /> 1332 52 3jy <br /> Si azure of auth jzed: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 /> s <br /> In case of emergency <br /> NAME: 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 /> paymenfobligxticins.. Licensees who fail to.correct their non-filing or delinquency vilt be subject to license suspension or revocation. This request <br /> is made under the authority"of Musachuseus;.General Law,Chapter 62C,Section 49A. <br /> The Cowutorrrveallit of Massachusetts <br /> BARNSTABI E ss I 4_.rw 7 _ t. DATE � 7 <br /> y� <br /> Personally appeared before me"the atio¢e•named � <br /> tid:rnade oath that the foregoing statement is <br /> true. <br /> A certi i sPas <br /> with. iss lion shall be in force and effectfor four years from the date of issue and shall be renewed <br /> each four yea. r er ZZ, <br /> be conducted and shall lapse and be void unless so.renewed. <br /> Signed " <br /> Notary Public <br /> • SEAL JOSEPH L..M A <br /> �n�cotutotmeALTH of , s <br />
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