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w <br /> BUSINESS CERTIFICATE#05=� <br /> THE COMMONWEALTH OF MA SSACHUSETTS <br /> TOWN OF MASHPEE ?i <br /> • DATE v G <br /> Expiration Da e: Dece er 31, 2009 <br /> In conformity with the provisions of Chapter one hundred and ten, Section five of the General Laws, as amended, the <br /> dersi d hereby declare(s)th afbbus' ess and r the title of <br /> t/ D AL is conducted a_ <br /> Business Location: (� <br /> Business Mailing Address: // i <br /> Business Type: G % Business Telephone: �O—. �s'v <br /> by the following named persons: <br /> FULL NAME RESIDENCE <br /> Home Phone: Z/ 7 ' <br /> _t <br /> certify u r th pe aft s of perjury that I, to the best of my knowledge and belief, have filed all state tax returns and paid all state <br /> n, <br /> 'es as r quired er la <br /> *Signature of individual By: Corporate Officer <br /> ,f�l/ 2, 2-T&;Fj? <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 tae filing nr rax <br /> payment obligations. Licensees who fail to correct their non-tiling 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 <br /> BARNSTABLE ss DATE-06Ch y 9005' <br /> ` � r <br /> Personally appeared before me the below namted O PfJ�"'�I- —Do n I G 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 year fter so long as such business shall be conducted and shall lapse and be void unless so renewed. <br /> Signed <br /> C' us <br /> " Public <br /> � <br /> sea uM� C. Notary <br /> NOTARY PUBLIC <br /> Com n at MMh <br /> 10 <br /> 00MCOYIdS"EVIMSIOLZ1.Y1C <br /> Commission Expires: <br />