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r <br /> • - BUSINESS CERTIFICATE#01C:::, 9 <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> • TOWN OF MASHPEE <br /> DATEi� (- <br /> Expiration Date: DAF, <br /> ),PL-'3 t-09 <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 titleof <br /> �lfl%c11 Vl3 U.f F1 /"YZC DNA- / a uu Gey' �lil2i y(7 /!kt is conducted at <br /> Business Location: <br /> Business Mailing Address: p' u o —770 u )z a a 'w/i` Oi Yv <br /> Business Type: Cs4�h i�iL/SOS Business Telephone: (o <br /> �1lpvitx Fief 1"u61ic <br /> CLL 11. "4e51C <br /> by the following named persons: _ <br /> i FULL NAME ^ RESIDENCE <br /> �' y=1 (v j G+-- <br /> Home Phone: <br /> certify 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 as required under law. <br /> *Signature of individual By:Corporate Officer <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-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(1���:. � <br /> Personally appeared before me the below named L��I om 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 ssJsuuuccch business shall be conducted and shall lapse and be void unless so renewed. <br /> Signed <br /> f'. <br /> • <br /> Margaret Notary Public <br /> NOTARY PUBLIC C. Santos Commission Expires: <br /> Cmnmm waalth ol:Massachusetts <br /> Ny Commi_Wm'Elpiie3 Sag 24.2010 <br />