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TOWN OF MASHPEE BUSINESS CERTIFICATE <br /> 'J <br /> Date: I 2 -7 L/ X <br /> • —rr/ <br /> Expiration Date: I /3f& 1S <br /> In conformity with the provisions of Chapter one hundred and ten, Section five of the General Laws, as <br /> amended, the undersigned hereby declare(s) that a business under the title of <br /> Business Name/DBA: Next Level Nutrition Corporation Name: <br /> is conducted at Business Location: 14 Joy Street <br /> Business Type: Nutrition <br /> New [J] Renewal [ ] --Commercial [ ] Residential [ ] Email Address: <br /> Ji U <br /> Business Mailing Address: 1 Wampanoag Way, D-6 Mashpee, MA 02649 <br /> Business Telephone: Home [ ] Cell [Phone: 508-813-2897 <br /> by the following named persons: <br /> Owner Name Owner Residence <br /> Sharon Morais 1 Wampanoae Way, D-6 Mashpee MA 02649 <br /> • 1 certify under the penalties of perjury that 1, to the best of my knowledge and belief, have filed all state tax returns and paid <br /> all s ate[axes as required under law. <br /> ( ihA /[ZA <br /> *Signature of authorized agent **Social Security Number (Voluntary) <br /> *This license will not be issued unless this certification is signed by applicant or Federal Identification Number <br /> In case of emergency ,, 1 c n r <br /> NAME: ['I )l lA 1_%YV pra*Y� TELEPHONE NUMBER: qCA 23q D:'M <br /> Alarm Company: MIA <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 Massachusetts General Law,Chapter 62C,Section 49A. <br /> The Commonwealth of Massachusetts <br /> BARNSTABLE, ss DATEQG' n tJrr Qiq Q�r aO)L! <br /> Personally appeared before me the above-named S •�tYGvy (�ovac:� and made oath that the foregoing <br /> i <br /> statement is 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 <br /> renewed e h four years thereafter so long as such business shall be conducted and shall lapse and be void unless so renewed. <br /> Signed Notary Public (1CA i �L <br /> • Com 'ssion Expires 04- a 7-r30 1 7 <br /> � .,'NotaryPublic <br /> �� `-MargarAt.C. Santos <br /> CormnomveaBh of Massachusetts <br /> Mf'Commission Efiplreson Sept.22,2817 <br />