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TOWN <br /> ori <br /> L\` TOWN OF MASHPEE <br /> Statement of Discontinuance, g ' g Change of Residence Change of Location of Business, <br /> �nuue co' <br /> Withdrawal,or Deceased from Business or Partnership,Change of Business Name or Owner Name <br /> DATE <br /> The Town is desirous of going"Green" as much as possible.To that end,please include your email address. <br /> Email Address:Chrls�Onl'1 rD6T 11117 <br /> Discontinuance <br /> In conformity with the provisions of Chapter one hundred and ten, section five, of the General <br /> Laws, as amended, the undersigned hereb} declares) that I/We has (have) this day discontinued (retired <br /> from) (withdrawn from) the business of +�P S NorYtc �rAmveffiefy <br /> conducted at 34 CaOr?0.W0.C�" R� mQ5�1dJ2P__ �4 lia lo'f <br /> STRE <br /> 4Z L <br /> SIGNATURE <br /> Change of Location of Business <br /> I hereby state that the location of the business/my residence as it appears on the Business Certificate filed <br /> on es 14"L i m(2C0 %f I0 Yle KNI has been changed to <br /> Name of BusinessII Mco Ido Q,r► ��;�e h <br /> ee -Ma Q49 <br /> '91IGNAIME <br /> Change of Name of Business or Owner <br /> I hereby state that the name of the business or the owner as it appears on the Business Certificate has <br /> been changed from b r�5L�pVw_c S_ obeg-`\on <br /> /(0-) <br /> f <br /> SIGNATU <br /> Notary <br /> Barnstable ss. <br /> Date <br /> Personally appeared before me the above named C� 'r uS W hw &('9d made oath <br /> that the foregoing statements are true. ^^ <br /> WMYCommimssionE <br /> Notary Public Name-Notary Public <br /> Margaret C. Santos � ICommomvealth of MessachuseflsCommission Expires <br /> xpires on Sept.22,2017 <br /> Origforrn/Discontinuance <br />