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aUDs=Sa <br /> F9 <br /> W' T`g M <br /> 'DOWN OF MASHPEE <br /> `57nm,e co.. <br /> Statement of lliscontinuance,Change of Residence, Change of Location of Business, <br /> Withdrawal, or Deceased from Business or Partnership, Change of Business Name or Owner Name <br /> S1 V69 <br /> DATE <br /> Discontinuance <br /> In conformity with the provisions of Chapter one hundred and ten, section five, of the General <br /> Laws, as amended, the undersigned hereby deelare(s) that UWe has (have this day discontinued (retired <br /> from) (withdrawn from)the business of _ C }� S L / <br /> conducted at <br /> S'I'REE <br /> Avi <br /> SIGNATURE <br /> Change of Location of Business <br /> I hereby state that the location of the business/my residence as it appears on the Business Certificate filed <br /> on has been changed to <br /> • Name of Business _ <br /> SIGNATURE <br /> Change of Name of Business or Owner <br /> I hereby state that the name of the business or the owner as it appears on the Business Certificate has <br /> been changed from <br /> to <br /> SIGNATURE <br /> Notary <br /> Barnstable ss. <br /> Date <br /> Personally appeared before me the above named and made oath <br /> that the foregoing statements are true. <br /> Name-Notary Public <br /> Commission Expires <br /> Ori gform/Discontin uance <br />