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' - BUSINESS CERTIFICATE#07� <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> TOWN OF MASHPEE <br /> DATE <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 as business under the title of 1 <br /> OrJklc\&k }' A( ORAL `/l)S DBA Auhrf (1� .�u�f is conducted at <br /> Business Location: I E OIAV SAI /� Kl—� <br /> I (? . <br /> Business Mailing Address: q Ye e MA 0 l21 % (/ �y n <br /> Business Type: I-RA�.Rt�Nt� ) Business Telephone: SW-b - y 17- /0 Jy <br /> by the following named persons: <br /> FULL NAME RESIDENCE <br /> Home Phone: <br /> I certify r er enalties of perjury that I, to the best of my knowledge and belief, have filed all state tax returns and paid all state <br /> s s r 'r �er law. <br /> j <br /> ignature fauthorized agent *Signature of authorized agent <br /> **Social Security Number(Voluntary) <br /> or Federal IdentTcation Number <br /> i In case o1'emergency <br /> NAME: /; Q,/ J TELEPHONE NUMBER: wS S <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 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 of Massachusetts <br /> BARNSTABLE ss 1 DATE ld-c) 7- Q4� <br /> Personally appeared before me the above-named //qU%�(,t� /Jti�Py 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 the afte so to g s such business shall be conducted and shall lapse and be void unless so renewed. <br /> J � <br /> 1 Votary Pub � <br /> SEAL = - �� Deborah F. Dami <br /> NOTARY PUBLIC <br /> Commonwealth of Massachusetts Commission Expires: <br /> My Commission Expires July 24,2009 <br />