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BUSINESS CERTIFICATE#055 <br /> r <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> TOWN OF MASHPEE <br /> DATE O&V 13A06y <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 /> D 'lets 94 DBA a' /��6 RA2 06' SB0/LZ>/y6 a is conducted at <br /> Business Location: q 172CA*VZe , ,, /�R, <br /> (� <br /> Business Mailing Address: 7 ' / ifA- ryR A.0 <br /> Business Type: ROMOCL / J4ViLIW&�Z-1111siness Telephone: $ 77eo" 3 j 3`j <br /> by the following named persons: <br /> FULL NAME RESIDENCE <br /> Home Phone: 6b la 51q mi-7 <br /> rtify under the e es of pe 'ury th o the best of my knowledge and belief, have filed all state tax returns and paid all state <br /> 1' es as re under law) <br /> *Signature of authorize ent *Signature of authorized agent <br /> q2- <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 DATErVW <br /> �Jr (may <br /> Personally appeared before me the above-named Mo S D I\fit-c.✓14 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 /> ARC-A L SCOTT <br /> Notan'Public oto ublic <br /> SEAL - Commom��ealth of Massachusetts. <br /> My Commission Gxpires A / a&V4D <br /> March 31.2006 <br /> Commission Expires: <br />