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` Y <br /> BUSINESS CERTIFICATE#06 -.5-LI <br /> • THE COMMONWEALTH OF MASSACHUSETTS <br /> TOWN OFMASHPEE �Jro/� <br /> DATE <br /> Expiration Date: December 31, 2010 <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 /> DBA <br /> INC s conducted at <br /> Business Location: �G -2 TA C✓ 1�ble Af!1"- tae A(/1 oz6//� <br /> Business Mailing Address: t7 U t JW4 0261(_9 <br /> Business Type: q(d y d 51 J�r t Business Telephone: <br /> 0 <br /> by the following named persons: <br /> FULL NAME RESIDENCE <br /> AW-6- o 026 y� <br /> Home Phone: <br /> 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 /> es as required under law. - <br /> *Signature of authorized agent *Signature of authorized agent <br /> **Social Security Number(Voluntary) <br /> or Federal Identification Number <br /> ,t / f/ In case of emergency <br /> NAME: yy� (f do ( 1l TELEPHONE NUMBER: / 3 _1� D <br /> Alarm Company: <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 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 uQn C -�<t) <br /> � <br /> Personally appeared before me the above-named Y tCC'A l/�O,lCA, and made oath that the for oing 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 thelaer so Ion/gas such business shall be conducted and shall lapse and be void unless so renewed. <br /> ed <br /> CX,t. CW <br /> e Margar@i I otary Public <br /> SEAL- NOTARY P t! <br /> Commonwealth of Masan:. - 9 a k- aol U <br /> 1Ay Commission Expires Sept.24,2010 Commission Expires: <br />