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+ BUSINESS CERTIFICATE#05 , <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> TOWN OF MASHPEE <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(s)that a business under the title of //�� <br /> \)-uo,n ��" n (� DBA /�(> �- is conducted at <br /> Business Location: �' C_1rC��Q:CCn 0\C�MIA ` \ �-P c M \ 046 q�9 <br /> p <br /> Business Mailing Address: �o'Cl/)tl� � J� (hcac MDS �p/��c�,S.\ 1 <br /> Business Type: Business Telephone: <br /> by the following named persons: M A 1 <br /> F' L�\ tZQSIME <br /> d lb�cti <br /> Home Phone: `Q S`(0Al� <br /> tify 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 /> s as required under law <br /> A <br /> r <br /> *Signature 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 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 subject 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 .i <br /> BARNSTABLE ss DATE � � 6I <br /> gyp\ x <br /> --- - --Personally appeared before me the below namedtJ�� Jit(iLI\� n 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 /> ( S <br /> - iDebOrSh F. DaMl Notary blit <br /> ;SEAL n NOTARY PUBLIC <br /> Commonwealth otPIIS y 24 Z0� <br /> My Commission Exp Commission Expires: <br /> 1r <br />