Laserfiche WebLink
to��_x or <br /> TOWN OF MASHPEE <br /> —t�o Statement of Discontinuance, Change of Residence,Change of Location of Business, <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: <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 hereby declare(s) that I/We has (have) this day discontinued (retired <br /> from) (withdrawn from) the business of `w ri-5 --t-fUna-t ?c 0ir1p1 VICE <br /> conducted at �� I Iva�IQYL 'GIi.iS hlq(, ,,t PV�(,$A PV1 ` 0-01-6L4Y <br /> STREET <br /> �� tQ,f� <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 has been changed to <br /> Name of Business <br /> SIGNATURE <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 -1 V11JATio,yn\ {Atnhtq'G <br /> to fVrJ rt a TA k tf S ee -L� <br /> o <br /> i <br /> W' <br /> SIGNATURE <br /> Notary <br /> Barnstable ss. <br /> Date <br /> Personally appeared before me the above named and made oath <br /> that the foregoing statements are true. <br /> Name-Notary Public <br /> Commission Expires <br /> Origform/D iscom i nuance <br />