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r <br /> BUSINESS CERTIFICATE#05 —C44 <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> TOWN OF MASHPEE i <br /> DATE 2M" 3y 2 W 5 <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 1`__ f `'� n <br /> lea 1£CIYIg (�i��etr1 l��Qn fYYIQ a DBAAII t+t� LO iAd t.,u.t` hErQvd N c6FIis conducted at <br /> Business Location:��'(6 '_�CLWe�, Cv6F, OV",SI F--u_ nq OoZ(a4? <br /> Business Mailing Address: SZri -- ff'5 �Gi,. a5 Cci-C-1£k II'tG..SGIP2�' n2 O„Z4Y9 <br /> BusinessType:Trrkxl4 kZfAZr-'. Apeud Business Telephone: <br /> by the following named persons: <br /> FULL NAM$ RESIDENCE <br /> �41�L1Frjrlf � C� tllan IRS;Tc�.�s<5 C�rc�� <br /> MA <br /> Home Phone: �O�y 1(e1y) <br /> 0ertify 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 <br /> require nder l/aww�. <br /> *Signa`atture of authorized agent *Signature of thorized agent <br /> DS5- � - 6o� <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 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 sub'ect 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 ��F`er ^ _ � `W'-) <br /> 1� DATE a4 2cr� <br /> Personally appeared before me the above-named .DF_ 8'10_.:0 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//s��oo business shall be conducted and shall lapse and be void unless so renewed. <br /> Signed <br /> C. swfts tart'Public <br /> SEAL NVAY .. <br /> dl $opt 24.21"O Ol, ai(- Flo <br /> r� <br /> WA <br /> my :110" Commission Expires: <br /> 'v,' <br />