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r <br /> r BUSINESS CERTIFICATE#05_Z(o <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> • TOWN OF MASHPEE <br /> DATE lIl/�bS' <br /> Expiration nate: 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 /> MF2- y K cryMoN7 DBA A-R-'r Fol 6t✓/niG is conducted at <br /> Business Location: 2-11 1=0yNT"q t d13 Sr <br /> Business Mailing Address: f.0 . b0 X `l0 3 <br /> Business Type: A-R-T Sry D I o Business Telephone: 5_0$- V`t 77 -z 1 Z) <br /> by the following named persons: <br /> FULL NAME RESIDENCE <br /> YvtgRy (z tG{{tdON � 2-9 "FoU )TA-ai 5r <br /> Home Phonc:50Q' - 'i"l1 - T; 7-1 <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 /> *Signature o indiv� 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 subiect 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 <br /> Personally appeared before me the below named I-ry>'��i. C�C_\nyrlona 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 /> Margaret C. Santos cJ s <br /> otary Public <br /> SEALNOTARY PUBLIC <br /> Commonweauh of ManachttMb <br /> 00VyC0=IW0nEx0resW24,2Q1Q <br /> Commission Expires: <br />