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BUSINESS CERTIFICATE A06 <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> • TOWN OF MASHPEE <br /> DATE .9d ne, 15- 1 �;W(. <br /> Expiration Date: December 31, 4901 <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 /J / <br /> / DBA ;�°"T% 2.�it i � ,�c ��pr�t`�is conducted at <br /> Business Location: /9 �r/Ges/'/IZ'l/ 116cl-ry", Gdy,Q <br /> Business Mailing Address: e- • <br /> Business Type/i�,r r `( ( Q i � Business Telephone: <br /> ��. <br /> by the following named persons: <br /> FULL N E RESIDENCE <br /> vl IPV, <br /> if <br /> Home Phone: _5 <br /> •I certify 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 /> taxes as required under law. <br /> *St ue of authorized agent *Signa ne of authorized agent <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 famished 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 subiect 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 l l tGt rt e J ha r e �s DATE 50ne- S l 0006 <br /> Personally appeared before me the above-named C- E h 14S 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. '•S" <br /> c <br /> Signed <br /> • /�!/-/ ` Margaret C tea, ' . <br /> NOTARY PUBLIC, tary Public <br /> SEAL Commonwealth of Massach.:sells <br /> Ny Commission Expires Sept.24,2010 <br /> c.-_ Commission Expires: <br />