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BUSINESS CERTIFICATE <br /> N� <br /> c\ o THECOd/iYIOArIVEALTIIOFMASSACIIUSF7'TS <br /> TOIVA'OF AIASHPEE DATE <br /> • Expiration Date: Lil <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: f)kf:7nr)f2.. RfeXr1irporation Name: is conducted at <br /> Business Location: 36o C" a rnbrI -G r• <br /> Business Mailing Address: Iv'a-,51 lOat L4-9 <br /> Business Type: NQ,i I 5tiAbn —Business Telephone: <br /> t��� $�J�.J/1 � <br /> Home Phm <br /> one: �g�����'T� Entail Address: (�C_n) r� mnn. (',DM <br /> by the following named persons: <br /> Owner Name r.•ncr I esidepce <br /> inn n a� 1--1. R ems, � n m r(d.ct� h r NI axshne� <br /> I certify under the penalties of perjury that I, to the best of my knowledge and belief, have filed all state tax returns and paid all state <br /> taxes as required under law. <br /> ' n <br /> gnare of authorized agent "Social Security Number(Voluntary) <br /> or Federal Identification Number <br /> *This license will not be issued unless this certification is signed by applicant <br /> �t J In case of emergency p <br /> NAME: L'hrl�5 'CLGTELEPHONE NUMBER: 1�'-F-2,3$laL 7 <br /> Alarm Company: N I PC <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 authoriryof ibfassachusetis General Law,Chapter 62C,Section 49A. - <br /> The Commonwealth of Massachusetts BA1hvS"f ABLE ss 5� DATE 47 <br /> 1 / <br /> Personally appeared before me the above-named PC—WA)01- �-`,� 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 rout years from the date of issue and shall be renewed <br /> each four years thereafter soo long as such business shall be conducted and shall lapse and be void unless so renewed. <br /> Signed <br /> Notary Public <br /> SEAL <br /> 1�t Con14¢IntyBtMdYpires: <br /> I COMMONWEALTH OF WS811CIMI8 <br /> MycartrivisianElom <br /> pftv25,419- <br /> I <br />