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i BUSINESS CERTIFICATE# <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> TO RIN OF MASHPEE <br /> DATE ( _q)1 'r2. <br />' • <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 a )business under the title of <br /> m / <br /> Business Na <br /> e/DBA: /r re, �LO/��/N<f� n Corporation Name: / <br /> ' is conducted at Business Location: � NLF'�/�,// // J Commercial_Residential 1� <br /> Business Mailing Address: �� S- Z /q s,�/� — Gm/4-q <br /> Business Type: usiiiess Telephone: <br /> Business Phone Home Phone:��L// / / ?$4 Email Address: <br /> by the following named persons: /I l A <br /> /ll/ 4L <br /> 1 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 /> 4V6 -Z7/9 <br /> tgnature 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 /> In case of emergency <br /> NAME:g"A! 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 susoension or revocation. This request <br /> is made under the authority of Massachusetts General Law,Chapter 62C,Section 49A. <br /> T/te Coatuanatvealrh ojn9rescachuserrs <br /> BARNSTABLE ss DATE <br /> Personally appeared before me the above-nantedd7:S—�(hr�Pl 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 long as such business shall be conducted and shall lapse and be void unless so renewed. <br /> Signed may _ <br /> � Y� <br /> Notary Public <br /> SEAL <br /> • !� CO, p�pNnialy ailic 11 <br /> COMMONWEAITM OF MASS1(ADCIrNNU <br /> Wto Tpt9Commh ar,E <br />