Laserfiche WebLink
AL <br /> BUSINESS CERTIFICATE#05L�U. <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> TOWN OF MASHPEE <br /> DATEM 1�jcJ <br /> Expiration Date: DeCemheY 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 /> SCfC�Ge� Lnocy1S zh &C4. DBA Sel qicZ- LO�R.T !n YE?l atx.is conducted at <br /> Business Location: 02 02- LAK- k;-X /1T--1, 1114 c9 <br /> r(S " �I <br /> Business Mailing Address: /Da L�D Ogv4eus zq oh , kiwr— ( T�tF b f �I < ct 9a"/C"-/ <br /> Business Type: Sae^ r'/ I\nstw-M Business Telephone: 8' — A0 V,21) <br /> by the following named persons: <br /> FULL NAME RESIDENCE <br /> Ptcno i t`�Pd &i&_tjz <br /> Home Phone: <br /> �e:My under the pen lties of perjury that I, to the best of my knowledge ans belie,`, have filed all state tax returns and paid all state <br /> es as requ red la <br /> *SignWe of au ize ent *Signature of authorized agent <br /> F110 : Rs-(347006-61 ,? <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 ofMassaehusells <br /> BARNSTABLE ss DATE ' I Q., <br /> Personally appeared before me the above-named JL' 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 fromthe 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 /> • Dborah F. Dand <br /> o� NOTARY PUSUC <br /> communweam 011mms s ft Notary P lic <br /> SEAi.- My�mWOn W <br /> %. .F, Commission Expires: - <br />