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BUSINESS CERTIFICATE#05 1� <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> TOWNOFMASHPEE <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((ss)^that a business under the title of <br /> C C��-\SSP (23rn 62Af:)\9^ [DBA J 1 n is conducted at <br /> Business Location: <br /> Business Mailing Address: <br /> Business Type & w13 Business Telephone: J( j ' 111,10 <br /> by the following named persons: <br /> FULL E RESIDENC <br /> fy)(1, 6 (�/q <br /> Home Phone:" <br /> � <br /> ertify 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 /> * ign of individual By: Corporate Officer <br /> 416 3j - ?1M' / <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 subiect to license suspension or revocation. This request <br /> is made under the authority of Massachusetts General Law,Chapter 62C,Section 49Al <br /> l y' <br /> The Commonwealth ojMassachusetts <br /> BARNSTABLE ss (( DATE%"�OS <br /> Personally appeared before me the below named Pnn FPt'. 'T PK6n 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 /> Mar,- 9arit Ci..Santos Notary blit <br /> SEAL OVy <br /> )NOTARY PUBLIC <br /> Commommeatth ot'Massachusetts GOIIctItWon Expires Sept.24,2010 Commission Expires: <br />