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..Y s co ry 's <br /> TOWN OFMASHPEE <br /> Statement of Discontinuance, Change of Residence, Change of Location of Business, <br /> -roti:,c h-awal, or Deceased from Business or Partnership, Change of Business Name or Owner Name <br /> DATE <br /> The Town is dsirous of going"Green" as much as possible. <br /> ^^Toythat end, please include your email address. <br /> Email Acldress:��I\\'� ����� ��• W t t 1 <br /> Discontinuance <br /> h conformity with the provisions of Chapter one hundred and ten, section five, of the General <br /> Laws, as amended, the undersigned hereby, declares) that I�V las (have) this day discontinued (retired <br /> from) (withdrawn from) the business of � r l�1 Cf� e <br /> conducted at � rJ <br /> ST E <br /> SIGNATU <br /> Chante 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 hue. <br /> • Name-Notary Public - <br /> Commission Expires <br /> 01 tgfon/Discontinuance <br />