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BUSINESS CERTIFICATE#051,5 <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 /> "l-!e DBA is conducted at <br /> Business Location: �y T �(XCC�S ,t�1 �,f 1 0 1ClS f\�IY� <br /> Business Mailing Address: <br /> Business Type: MA Business Telephone: <br /> by the following named persons: <br /> �IJ i�L L4 <br /> Home Phone: Nates-�l &O <br /> rtify under The penalties of perjury that I, to the best of my knowledge and belief, have filed all state tax returns and paid all state <br /> es uired under la <br /> *Si e of aut ed agent, — *Signature of authorized agent <br /> oaf V ! y(.)1 <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 /> "Your social security number will be furnished 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-tiling 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 DATEoZO'V5' <br /> Personally appeared before me the above-name ��1 d 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 /> MA ota L SCO1'f <br /> Notan Public <br /> (,'pmmomcealth of Massachusetts <br /> My Commission Expires p�hc <br /> March 11.1006 <br /> SEAL -- s-.31—d h <br /> e� CommissionExpires: <br />