Laserfiche WebLink
BUSINESS CERTIFICATE#06—sci <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> TOWN OF MASHPEE <br /> • DATE <br /> Expiration.Date: December 31; 298 a607 <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 <br /> under the title of <br /> -6-0�1�►L�7�� �Zt� BA s conducted at <br /> Business Location: SS—'S- <br /> Business <br /> SS <br /> C <br /> Business Mailing Address: 1'L `7 <br /> Business Type:w S I T"I I n Q I jo �1 l l)0ansi�i ess Telephone: Tp a -S 3 ,� -3 g U c) <br /> by the following named persons: <br /> FULL NAME RESIDENCE <br /> I4 b,e,l 1 SSS C t r4LA <br /> Home Phone: �p s� —.34o(j <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 /> tax as required under law. p <br /> / O dt - `k R (i(,1�1 <br /> signature of authorized agent *Signature of authorized agent <br /> baQ-Se -�K � <br /> **Social Security Number(Voluntary) <br /> or Federal Identification Number <br /> f 'L n In case of emergency y <br /> NAMEM r 1 QA) 1 L F I TELEPHONE NUMBER: s%S3 9- n J <br /> *This license will not be issued unless this certification is signed by applicant <br /> **Your social security number will be fumished 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 ojMassachuseas -� � <br /> BARNSTABLE ss DATEJG��1 � r�rl (a <br /> Personally appeared before me the above-named -U'l�r V Y},(�, 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 assuch <br /> - ���such business shall be conducted and shall lapse and be void unless so renewed. <br /> Signed nllllll <br /> ,u- 1 h O _ <br /> . S <br /> • - <br /> OlAy <br /> Notary Public <br /> Margaret C. Santos q 'a(1-6V(7 <br /> NOTARY PUBLIC Commission Expires: <br /> Commonwealth oi.Massachusetls <br /> Commission Expires Sept.24,2010 <br />