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BUSINESS CERTIFICATE#05 ^3 <br /> o z <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> TOWNOFMASHPEE <br /> • DATE l - zS -6S <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 /> JkMES p • t (Z/otR 4 DBADUAUvs' J6 &6 2WE Q.l$(3W YftE(S is conducted at <br /> Business Location:2_7S CZ701`� RID- <br /> Business <br /> ID. t <br /> Y»s�l�e T9-ACt—StD6 rAODEL_, ✓c. <br /> Business Mailing Address: 2-?g CG-vU IT )� b Q Z C Lt <br /> Business Type: IN U2. L-'&t2 Business Telephone: S 9 - to q S <br /> by the following named persons: <br /> FULL NAME RESIDENCE <br /> Home Phone: <br /> I certify 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 /> Oes as required under law. <br /> S} re o in ividua By: Corporate Officer <br /> 02 28 15 <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[ax 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 I <br /> Personally appeared before me the below named Jt-) M PS 4;la p-u 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 or 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 /> Signe <br /> Notary Public <br /> 11A9Pg�f@t,'C. .SBfltOS <br /> SEAL ajaj, _ .. <br /> IVIYf.Ti NOTARY RUBLIC = g-� �/'cZ/y <br /> CoWhonweahh Othlassachusft Commission Expires: <br /> W WM11891tu1 EKOm Sapf,24,Z01U <br />