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BUSINESS CERTIFICATE#05=,39 <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> TOWN OF MASHPEE <br /> • DATE J-11 (] <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 trader the title of �l J <br /> .to (11 SSaC' i Ott S DBA )�V �Jy IOLIJ is conducted at <br /> yt l 1 I <br /> Business Location: i t�I/4 Y k,�L [ S f P s } /J0 y�tJL� �"�/ o <br /> Business Mailing Address: .C/� /7!}7{ ) y p r tQ-..5A m i1 d0 (0 S <br /> Business TypeooT0)'uhr( C. AaLl-1 C, Business Telephone: <br /> by the following named persons: <br /> FULL NAME /_ RESIDENCE � / ry� <br /> As ft ,:5tq u 'L I /COY q/� l / t �`5r_, <br /> LG Y_% r'.Q G( Lk-t 7NkO 5 .S4 LY,Yrs 1�l1 r S �a)1 s" fit r�f <br /> Home Phone: <br /> 513 Q'a y6a I <br /> ,goLcertify 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 <br /> aasss required under law. <br /> *Signa e of individual 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 applicaut <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 licensesuspension or revocation. This request <br /> is made order the authority or Massachusetts General Law,Chapter 62C,Section 49A. <br /> The Commonwealth of Massachusetts BARNSTABLE ss n \ DATE y 5'�- I- <br /> Personally appeared before me the below named gu\bC r' Crn r±a r� 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 J <br /> • C� <br /> SEAL o <br /> (Il�a/9and Ci. .Sa1tm Notary Public <br /> &NOTARY PUBUC <br /> QOIMOOOYIIE81lh Of II Commission Expires: <br /> My Commisdw Eltphes'W 24,2010 <br />