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'c BUSINESS CERTIFICATE#OS—53 <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> TOWN OF MASHPEE <br /> • DATE Q <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 /> 1 <br /> I� a(-, o L DBA An `' SU 2E �� t C YC L' is conducted at <br /> Business Location: 36 <br /> Business Mailing Address: <br /> Business Type: A 1{�-L /j Business Telephone:(_—lj d6 7 —S� <br /> by the following named persons: 1 <br /> FULL NAME RESIDENCE <br /> / LAX-OV- ZA j <br /> TA:J✓It<'C <br /> Home Phone: <br /> 0r[ify under the penalties of perjury that I, to the <br /> best of my knowledge and belief, have filed all state tax returns and paid all state <br /> s� ed der law. <br /> 6 X02 <br /> *Signature of individual By: Corporat ficer <br /> 6-733 <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 <br /> BARNSTABLE ss p DATE 3 ? 0s <br /> Personally appeared before me the below named _RYA0 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 /> 'IVIfVl11�/AVV/(L 1-- -- <br /> • Notary Public <br /> SEAL <br /> Commission Expires:2-2 5-28 i t <br />