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BUSINESS CERTIFICATE# IU Sq <br /> THE COMMONIVEALTH OF MASSACHUSETTS <br /> • TOWN OF MASHPEF. <br /> DATE 3 - t'�;_ - aa �a <br /> Expiration Date: 3 — 3 \ a C)\ y <br /> In conformity with the provisions of Chapter one hundred and ten, Section five of the General Laws, as amended, the <br /> undersigned hereby declare(s) that a busunder the title of <br /> y� <br /> kzf X ����/V�SO ines JDBA ABED/ C,0d C11,E1 D . �L�- / (/�J is conducted at <br /> Business Location: /� �� ��V�, /"/�fl/j�� a7 f� 7 / ' Sof <br /> Q <br /> Business Mailing Address: S 066 02,6 <br /> Vi <br /> f / <br /> Business Type: Lil/t4/1 z p ric//z Business Telephone: S-0 L ' <br /> Home Phone: <br /> by the following named persons: <br /> FULL NAME RESIDENCE <br /> Lo2N/9 . Top nom— 39' /0.9PN6M�>�' <br /> o�y <br /> I certify under the penalties of perjury that I, to the best of my I:nowledoe and belief, have filed all state tax returns and paid all state <br /> • <br /> xes as required under law. <br /> _'4., 4�r Oa <br /> *Sienature of oath ized agent *Signature of authorized agent <br /> z s - i90 ys 3 <br /> **Social Security Number(Voluntary) <br /> or Federal Identification Number <br /> / In case of emergency // y T/ <br /> NAME: Ld,kA14 r , JU��NSOAI TELEPHONE NUMBER: ��61F' V7 <br /> Alarm Company: <br /> *This license will not be issued unless this certification is signed by applicant <br /> "Your social security number will be furnished to the Massachuseus Department of Revenue to determine whether you have met tax filing or tax <br /> payment obligations. Licensees who fail to correct their non-filing or delinquency will be subject to license suspension or revocation- This request <br /> is made under the authority of Massachusetts General Law,Chapter 62C, Section 49A. <br /> The Commonwealth of Massachusetts <br /> BARNSTABLE ss DATE <br /> Personally appeared before me the above-named (.01-/I& 300 it S Or7 - and made oath that the foregoing statement is <br /> 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 renewed <br /> each four years thereafter so� long as such business shall be conducted and shall lapse and be void unless so renewed. <br /> tied -4 <br /> Margaret C. Santos otary Public <br /> SEAL <br /> NOTARY PUBLIC //� (/ <br /> (� ' Commonwealth of Massachusetts `1"d �-a <br /> Sly Commission Expires Sept.24,2010 Commission Expires: <br />