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2015
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Last modified
11/17/2016 3:11:02 PM
Creation date
11/13/2016 10:16:47 PM
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BoxNumber
Box 038
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R))y,fonry pin <br /> `$ TOWN OF MASHPEE <br /> Statement of Discontinuance,Change of Residence,Change of Location of Business, <br /> Withdrawal,or Deceased from Business or Partnership,Chn e of Business Name or Owner Name <br /> Ill can 6zr 30l 20[-- <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 from)(withdrawn from) the business of <br /> conducted at <br /> STREET <br /> SIGNATURE <br /> Change of Location of Business <br /> 1 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 4. 3&W.5 CA) TO 15,el C. TOHNS6� <br /> to <br /> GNATUR <br /> Notary <br /> Barnstable ss. <br /> Date <br /> Personally appeared before me the above named Zzy'n t d t., and made oath <br /> that the foregoing statements are true. n <br /> Deborah Dami T p'? y Publ <br /> NOTARY PUBLIC Name-Notary Public <br /> Commonwealth of Massachusetts <br /> My Commission Expires July 29,ZU16Commission Expires <br /> Origform/Discontinuance <br />
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