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BUSINESS CERTIFICATE#07'0& <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> TOWN OF MASHPEE <br /> DATE /U/ <br /> Expiration Date: December 31, 2011 <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 /> 1Lo.O�vx�gCfZ Py DBA pVA��,al,�� e�eICZA-� is conducted at <br /> Business Location: <br /> Business Mailing Address: <br /> Business Type: t� Business Telephone: ,�-V -6/77— 6UPoc" <br /> by the following named persons: <br /> � FULL AME RESIDENCE <br /> Home Phone: '-5-0-F — <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 /> We s as ret red under law. <br /> *Signature of authorized agent a *Signature of authorized agent <br /> �/�o1�S4S�7 <br /> **Social Security Number(Voluntary) <br /> or Federal Identification Number <br /> //'' In case of emergency <br /> NAME: /��/�.� r� ^M._ TELEPHONE NUMBER; <br /> .Sp�CJS 7� <br /> t� <br /> Alarm Company: <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 DATE /6-6 - o)006 <br /> I <br /> Personally appeared before me the above-named ��p��I �0e ezr 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 /> �ed <br /> h _ 2 <br /> _- Ma192Iet C..Sar Notary Public <br /> SEAL ° NOTARY PUBLIC <br /> Commonwealth of Massachusetts _ <br /> My Commission Expires Sept.24,2010 <br /> Commission <br />