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BUSINESS CERTIFICATE#05�N <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> TOWN OF MASHPEE <br /> DATE S13_ ) O S <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 /> /Cher e r>05 DBA 4&n�a�h OE',Ta/G e is conducted at <br /> Business Location: 12— ma kt-ef s54- 1!ff � 1Jf/Ig shy m4 62-&V 5 <br /> Business Mailing Address,:/ 1 /��X , 7�Z /t'LasY6�rl /� �Zty o <br /> Business Type: ��'/a �.�. Business Telephone: JPO/CSS' -%77' f&70 <br /> by the following named persons: <br /> 9 nh1iGhaeloma �sM1_5W/ laas Road ,)%M5_�h/e /ng <br /> rssica T. !dna/dst�, 6!9A11-e' 230 <br /> Home Phone: <br /> - 375- 1 ©9�O <br /> Lertify 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 authorized agent *Signature of authorized agent <br /> 20 So �-f 3 <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 Commonweahh of Massaehuseus 2 ) <br /> BARNSTABLE ss u 1 I DATE J <br /> Personally appeared before me the above-named )\)OV A 60 n 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 /> OvYcwa"wEvWJulY24.2W9 <br /> Deborah F. Delmi <br /> SEALNOTARYPUSUC. Not blit <br /> CWammulA <br /> « Commission Expires: <br />