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BUSINESS CERTIFICATE#07L1a <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> • TOWN OF MASHPEE <br /> DATE 21 AJ&V d (a <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 ,Q /- /a <br /> VG RAJ FEZ 0 b. Lkv/(."C* Q DBA ' 0 "'0-4) �T�+ �yL laagp0TC6 is conducted at <br /> Business Location: 45 r'-EO&r5'*CF, E <br /> Business Mailing Address: PO. go� $1. AA-* <br /> Business Type: kdc Business Telephone: ZAP 2.3 r 904 7Z <br /> by the following named persons: <br /> 11 <br /> ,FU)L NAME RESIDENCE <br /> Home Phone: <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 /> ts s require der law <br /> *S ature o aut orized agent *Signature of authorized agent <br /> t SNG M3 <br /> **Social Security Number(Voluntary) <br /> or Federal Identification Number <br /> In case of emergency <br /> NAME: TELEPHONE NUMBER: <br /> Alarm Company: <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 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 MassacJutsetts dJ rr <br /> BARNSTABLE ss // DATE NQ✓. <br /> Personally appeared before me the above-named (6-c-✓ h E 1'k 1), 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 [apse and be void unless so renewed. <br /> fd \ <br /> - - Notary Public <br /> SEAL: Deborah F. Dami <br /> f NOTARY PUBLIC <br /> Vyp Commonwealth of Massachusetts Commission Expires: <br /> My Commission Expires July 24,2009 <br />