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BUSINESS CERTIFICATE#06 37 <br /> • THE COMMONWEALTH OF MASSACHUSETTS <br /> TOWN OF MASHPEE <br /> DATE <br /> Expiration Date: December 31, 2010 <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 /> DBA CrN'V t CC'O — ErAfC&Ss conducted at <br /> Business Location: V7 Q Q_pO a Qqj <br /> Business Mailing Address _`� rYt Q <br /> Business Type: �( jp{�� 1 Business Telephone: ��©g 3g O <br /> by the following named persons: - <br /> LL -7 00SM0 LVE � m MAA A�©�R <br /> Home Phone: 50% s 3 ! 3 <br /> ertify 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 /> ,!!es as re wired under law. <br /> *Signature of authorized agent *Signature of authorizedagent <br /> 03.1 q- (0 � 3a_ <br /> **Social Security Number(Voluntary) <br /> or Federal Identification Number <br /> In case of emergency <br /> NAME: )Q�-t' o fes{v S TELEPHONE NUMBER: j-nlk- 53? <br /> 000 3 <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 sub'ect to license suspension or revocation. This request <br /> is made under the authority of Massachusetts General Law,Chapter 62C,Section 49A. <br /> The Commonwealth ofMassachasens J / <br /> BARNSTABLE ss DATE <br /> �\,\\, <br /> Personally appeared before me the above-named K _SA WNa_A is 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 to yea er so long as such business shall be conducted and shall lapse and be void unless so renewed. <br /> �e <br /> Uyrgaret C. Santos <br /> NOTARY PUBLICSEAL Commonwealth of Massachusetts totary Pub is <br /> Commission Expires Sept.24,2010 <br /> S - a4-�,ItJ <br /> Commission Expires: <br />