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BUSINESS CERTIFICATE#07 Ik <br /> • THE COMMONWEALTH OF MASSACHUSETTS <br /> TOWN OF MASHPEE <br /> DATE �2.•(L-bio <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 trader the title of <br /> Mt��AUt .l 7fn1A%R, L H��1hJrrSS�e"1 DBA (�{� '(� SI�tQP� is conducted at <br /> Business Location: AUQ S-T�,�!_-r S-TR- l ttt rAASS � PAA ok6 Y(,g <br /> Business Mailing Address:10 CC (l6-1L MA&4-e� AA- CG6W: � -y'1 <br /> Business Type: Business Telephone: DO -' 1 1 G <br /> by the following named persons: ��� <br /> FYLL NAME' 1I RESIDEN <br /> Home Phon,glie� p� Yl��l J�• �t�-G1 <br /> ertrfy under the penalties of perjury that I, to the best of my knowledge and belief, have filed all state tax retums and paid all state <br /> s as re u red under law. <br /> *Signature of authorized agent `Si a ue oauthorized agent J <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 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 <br /> 1�1(C(0.(1xl �} I+CYII�eS��f <br /> Personally appeared before me the above-named and made oath that the foregoing statement is <br /> true. PVI►'l.tSMy <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 /> CTSE1 re <br /> tc'a.� <br /> SEAL <br /> Nota <br /> �O&Voon E><vveo,twY2S.sL% <br /> Commission Expires: <br />