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BUSINESS CERTIFICATE#05::�6 <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> . TOWN OF MASHPEE <br /> DATE <br /> Expiration Date: December 31, 2009 <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 business under the title of <br /> 4Z z7 1,7.1 <br /> d � s conducted <br /> at <br /> Business Location: <br /> Business Mailing Address: <br /> Business Type:_ dzec/r� Business Telephone: _ <br /> by the following named persons: <br /> FULL NAME �t / RE IDENCE <br /> S— <br /> �! <br /> Home Phone: (� <br /> WS <br /> ify under the penalties of perjury that I, to the best of my knowledge and beliefavefiledall tate tax returns and paid all state <br /> a7�Torized <br /> . nder law. <br /> *Signaagent *Signature of authorized agent <br /> **Social Security Number(Voluntary) <br /> or Federal Identification Number <br /> *This license will not be issued unless this certification is signed by applicant <br /> **Pour social security number will be famished to the Massachusetts 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 Cor wealth of Massachusetts <br /> BARNSTABLE ss �o32ikc l y C DATE aAc4_,e2-V,-Acbs <br /> Personally appeared before me the above-named L/� `xJrnwv`— 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 /> Signed <br /> MARIT.A L.SCOTT <br /> is Nolanolaotan Public <br /> Commomrealth of Massachusetts. Nota Pub. c <br /> Mc Commission Expires ry <br /> sJAL March 31.2006 <br /> Commission Expires: <br />