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} « BUSINESS CERTIFICATE#OSAj THE COMMONWEALTH OF MASSACHUSETTS TOWN OF MASHPEE rr • DATE �C 7 I 26OS� Expiration Date: December 31, 2009 In conformity with the provisions of Chapter one hundred and ten, Section five of the General Laws, as amended, the undersigned hereby declare(s)that a business under the title of e'_d L1inJ iGI1_-1—_> DBA iM A 2 K4_T PLS L'c D is conducted at Business Location: 22q MJSK�'f t 04P"0'19�_5 em Business Mailing Address: Pb PJ6X MA-5l+j? 5 MA A '2_ `i'Qj Business Type: '&nfAKj &y ru4,7A6— Business Telephone: Shu- els 1Dy� by the following named persons: FULL NAME RESIDENCE ceukl fi-77 -&-c rz +Lo 79 M05VA-1 t_AiJ w A-514 rf-s mA- Home Phone: 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 Ankes as required under law. *Si e of�Lvidual By: Corporate Officer A7 � IX **Social Security Number(Voluntary) or Federal Identification Number *This license will not be issued unless this certification is signed by applicant **Your social security number will be furnished to the Massachusetts Department of Revenue to determine whether you have met tax filing or tax payment obligations. Licensees who fail to correct their non-filing or delinquency will be subject to license suspension or revocation. This request is made under the authority of Massachusetts General Law,Chapter 62C,Section 49A. The Commonwealth of Massachusetts BARNSTABLE ss DATE Personally appeared before me the below named and made oath that the foregoing statement is true. 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 each four years thereafter so long as such business shall be conducted and shall lapse and be void unless so renewed. - Signed SEAL_, „ Deborah F. Dam i Notary P ie NOTARY PUBLIC " ---- - Commonweafth of Massachusetts Commission Expires: +.; My Commission 60res Jury 24,2009