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'Commonwealth of Nlwsss hyset fs rrc <br /> Atcoholic:Bever.�&9 s Cxjiifirtrt�arrirnfss or.i <br /> - 95 Foul th Street,51rftc 3 <br /> Chelsea,MA 02150 <br /> JCr1.1 31•LtTWZIl7 LS�) . .. <br /> I1tAfrl) - <br /> hc Alccihalte e vc ra);cs Goniiiil Canaiiit ilr3it ("r1E3G C") ltfta.been cc rtitied hy:ilte Cri miIIAI 13 atory SyStetna:Board is aceegs: <br /> tialivjctiait tiiitl pen .0 nm. Il t}fC tidcr 12c sciiel lnlarrit�ttit>n:,(''CCll27'':)' t cRt lfi:e purpitys c f d }irt5vjnl; cacti 4l are t7alder;:o, ne ri <br /> Irs uts�c:t�t z�plili alitistl ticgt uttL i!veraL�s ItoLnse,:t.itnderswnd that a c inii.641 re.f ai¢:ehecte.wilt bL e�iiutuutd:on m€; puraLtastt <br /> .. .... <br /> to,the nl�o�lt:.T1tc�u7fc�rmattvn b�l;�w is ari.rt�ct:ta'llte bt.st c4.i nay krit�ulc.etl;c: <br /> w. <br /> ABGC NUMBER D0673 RS Q674 LICENSEE NAME Mashpee:Orient al,Inc CITY TOWN Mashpee'' <br /> . <br /> APPLICANT INFORMATION <br /> j LAST NAME Huang: FIRST NAME Rjcicy :MIDDLE NA Zhong C1+nB <br /> I <br /> MAIDEN NAME OR ALIAS(IF:APPLICABLE): �: PLACE O).BERTH.'::Fuzhou Chfna <br /> III , <br /> !.DATE OF BIRTH:. i SSN; �. ID THEFT iNDEI(PIN:CIF APPLICABLE} <br /> M07HER`S MAIDEN NAME Xtanmer Lou �T— DRIVERS LICENSE# I I STATE LIC;ISSUED: MaSSaGhusedS <br /> { _I <br /> GENDER: MALE + HEIGHT ifi6 5 . WEIGHT LYE COLdR Ell <br /> Brown <br /> T. <br /> rr <br /> CURRENT;ADC1RE55>. _ <br /> CIT1/TOWN Redeye' STATE: tv1A <1F v Ira <br /> FORMER:ADDRESS; <br /> CITY/TQWN Boston STATE rfv1A; ZIP 02111 <br /> !'PRINLAND St&N,: <br /> 1 ffINTED NAME RItky Zh4rtg Qing Huarfq J APPLICANT/EMPt0YVE SIGN A7URE } <br /> l <br /> w <br /> " <br /> ...NOTARYINhCENA7ATfON'.:: ,.-: _ <br /> On of fs '. before fine the,undersigneed notary public,personally appeared Ricky Zhang Qrng Huang: <br /> (name of document signer),proved.to me through satisfactory evidence of identification,which were drwer'S license <br /> to be,;the perspn.whose name-1,signed on.t the preceding ur attached document,and aci" iedged to me that f h l).(51i .'...tired it Voluntarily for., <br /> its.stated purpose: <br /> NOTARY <br /> SUNDEEP DHUNGANA <br /> rl �t <br /> No <br /> Cointon m�Mwtacru,wfts <br /> M Com ' slon <br /> giVisjmOsr:oNUY l`: �zplresDec 6,.202d <br /> ..�uNA711Rp Nf/.xUr4�.R.i11 itT`1`ttf �u•.� . � .. .. <br /> TueUiJ Itlenirf'rhufi rout t+lh I,ur;IP. s Io DP ti;rlw I.Ies.In i{+e t• . .. .. .. '.. '..y., 1'lI1D'C+I IiY11 AI ll+Ni t4ln•>5�t^.4:•111(HI'ItVll:(fl ". '.' .. .'. .'. .. <br /> Plt/hu tCf'CV'•hC''4.,''11_(W{IIIPtl.I�'L KIlf yll .,,V.11l fG,Dr(i�00, D t.trtlr r!II'tl.:(ICrl.rwrl 9 t+�Lt :f15 ' ' - <br /> ;IrinrM$t<n in frsuo'h +ILCV:PCT'VI i con.w6.kV.4tlCC+tY, *a.[Wµ 4qu"t rDIID1.fhdt In .1 'Ihn+f,.w i,j <br /> ieµvir'dtl tD Oe culimiatBtDtAiUUI�a m511,Dr by la)i!IG}7je88-celd '' .. __ <br />