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BUSINESS CERTIFICATE# <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> TOWN aF MASHPEE <br /> DATE 1.2 Ll Xa <br /> • Expiration Date: <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 abusiness under the title of <br /> Business Name/DBA: (__7' <br /> /• 1aZ(l 1A50r16CJ20Qe Corporation Name: <br /> is conducted at Business Location: xo <br /> L4APe✓cy / !9r Commercial Residential <br /> Business Mailing Address: f�r7 Ly // cab 5b I � . o' .Aq cl <br /> Business Type: L ,,r�cr•.r�.o ron,<Iruc l;iki Business Telephone: S08'ffo?-8545 <br /> Business Phone Home Phone: Email Address: ass6lan sc <br /> by the following named persons: yahoo•CO W) <br /> //Owner /Name Owner Residence <br /> Orr:skpAel' koUSEo <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.'/Q <br /> ature of au prized 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 /> 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 /> 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 of Massachusetts <br /> BARNSTABLE ss ` DATE <br /> Personally appeared before me the above-named� V' t\ < V I xcJS0 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 thereafter so elong as such business shall be conducted and shall lapse and be void unless so renewed. <br /> Signed �L � • <br /> . 1111 ) f�y �Pubhc <br /> Ntary <br /> • SEAL <br /> VICKI ANN GOVOM <br /> e��l Commi LTH OF ' <br /> . J 11Iq I�coreeoemFaun eon JCttu <br />