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' S ; <br /> 4�`Y:OWN <br /> 'r9 <br /> y TOWN OF MASHPEE <br /> Statement of Discontinuance,Change of Residence,Change of Location of Business, <br /> Withdrawal,or Deceased from Business or Partnership,Change of Business Name or Owfier Name <br /> Q 2c iu7 <br /> � r <br /> 0 DATE <br /> Discontinuance <br /> In conformity with the provisions of Chapter one hundred and ten, section five, of the General <br /> Laws, as amended, the undersigned hereby declares) that I/W has (have) this day discontinued (retired <br /> from) (withdrawn from)the business of u�t1't uIS I <br /> 1 S t2 i v r P-w) <br /> conducted at 3 U Pj0� <br /> STREET <br /> b <br /> IGNATURE <br /> 2�s r'-CQ <br /> Change of Location of Business <br /> I hereby state that the location of the business/my residence as it appears on the Business Certificate filed <br /> on. has been changed to <br /> Name of Business <br /> • u�s ,��t us ('�-1-� t�JQ51- r/t ceS�t Pte. <br /> ATURE <br /> Change of Name of Business or Owner <br /> I hereby state that the name of the business or the owner as it appears on the Business Certificate has <br /> been changed from <br /> to <br /> SIGNATURE <br /> Notary <br /> Barnstable ss. <br /> Date <br /> Personally appeared before me the above named and made oath <br /> that the foregoing statements are true. <br /> Name-Notary Public <br /> Commission Expires <br /> Origform/Discontinumee <br />