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t'J y BUSINESS CERTIFICATE tt <br /> THE COMMONWEALTH OFMASSACHUSETTS <br /> TOWN OF MASHPEE <br /> • DATE <br /> Expiration Dat <br /> In conformity with the provisions of Chapter one hundred and ten, Section five of the General Laws, as amended, <br /> the undersigned hereby declare(s)that a business under the title of <br /> Business Name/DBA: Barks and Bubbles Corporation Name: <br /> is conducted at Business Location: 35B South Street Commercial <br /> Residential <br /> Business Mailing Address: PO Box 403 PO Box 403 <br /> Business Type: Dorg Boutique/Grooming Telephone No. 508-419-4434 7 OVj <br /> New Renewal 17 I Home Phone: Email Address: <br /> by the following named persons: <br /> Owner Name Owner Residence <br /> Jefferson DeLeon Jefferson De Leon <br /> I 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 required under law. <br /> • "Signature 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: TELEPHONE <br /> 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 <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 e_� �� �� ` DATE <br /> Personally appeared before me the above-named J Q- and made oath that the foregoing <br /> statement is true. <br /> A certificate issued in accordance with this section shall be in force and effect for four yrs from the date of issue and shall be <br /> renewed each four s thereafter so long as such business shall be conducted and shall lapse d b void unlessnewed. <br /> Signed fr� Notary Publi <br /> • NOTARY PA"A'K <br /> IC <br /> Comm s' cTMC.I:,;..-1,;:�1USt1tS <br /> .i My Cantu,Expire:.Oct. t S,2020 <br /> Seal <br />