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BUSINESS CERTIFICATE <br /> TOWN OF MASHIPEE <br /> • Date: 1 <br /> Expiration Date: <br /> In conformity with the provisions of Chapter 110, §5 of the Massachusetts General Laws, as amended, he <br /> undersigned hereby declare(s) that a business under the title of <br /> Business Name/DBA: Sue B. Do Corporation Name: <br /> is conducted at Business Location: 259 Shore Drive Certificate No. 2010-078 <br /> Business Type: Retail <br /> New [ ] Renewal [/, Commercial [ ] Residential [ ] Email Address: suebdo@verizon.net <br /> Business Mailing Address: 32 Hastings Street Wellesley, MA 02481 <br /> Business Telephone: 781-354-3539 Home [ ] Cell [ ] Phone: 781-235-1939 <br /> by the following named persons: <br /> Owner Name Owner Residence <br /> Susan Zimmerman 32 Hastings Street Wellesley, MA 02481 <br /> •certify under the penalties of perjury that I, to the best of my knowledge and belief, have filed all state tax returns and paid <br /> all state taxes as quired under law. <br /> Od • 46— yLs"y <br /> *Signatu of authorized agent **Social Security Number <br /> *This license will not be issued unless this certification is signed by applicant or Federal Identification <br /> Number(Required) <br /> In case of emergenc�yJ L <br /> NAME: taw L f ✓1 ✓t1 (/ r�t I-4^ TELEPHONE NUMBER: [ , •x'39-331 <br /> Alarm Company: <br /> *'Your social security number will be furnished to the Massachusetts Department of Revenue to determine whether you have met tax <br /> filing or tax payment obligations. Licensees who fail to correct their non-filing or delinquency will be subject to license suspension or <br /> revocation. This request is made under the authority of Chapter 62C,§49A Massachusetts General Laws <br /> The Commonwealth of Massachusetts <br /> BARNSTABLE: ss DATE <br /> Personally appeared before me the above-named and made oath that the foregoing <br /> statement is true. <br /> 0 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 <br /> enewed each four years thereafter so long as such business shall be conducted and shall lapse and'be void unless so renewed. <br /> Signed Notary Public <br /> Commission Expires <br />