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` BUSINESS CERTIFICATE#07:77, <br /> • THE COMMONWEALTH OF MASSACHUSETTS <br /> TOWN OF MASHPEE n <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(ss)that a business under the title of <br /> y67 lterH DBA sncSlho is conducted at. <br /> Business Location: �r�-+yq n <br /> Business Mailing Address: �6 /w liNd.--H <br /> Business Type: Business Telephone: <br /> by the following named persons: <br /> FULL NAME RESIDENCE <br /> `��,., (J �.`//ems �Lf��cn/�L� L•-icS�i�e�h��J. QZ�� <br /> Home Phone: <br /> *ce t of my knowledgeand belief, have filed all state tax returns and paid all state <br /> es s req ed under law. <br /> *Signa a of author zed agent *Signature of authorized agent <br /> **Social Security Number(Voluntary) <br /> or Federal Identification Number <br /> c� .In case of emergency <br /> NAME: R/_&od/a k,'Iler TELEPHONE NUMBER: <br /> Alarm Company: 1 9 ekjr/ lar-zr/ <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 g O <br /> r_ I 11 ,,11 <br /> Pe onally app ed before me the above-named 40\'\ N W . M Jam.f— and made oath that the foregoing statement is <br /> true. <br /> certifica 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 y s the after so long <br /> ass such business shall be conducted and shall lapse and be void unless so renewed. <br /> ned <br /> �,yR <br /> COMMONWEALTH OF MASSACHUSEM - <br /> _ , - - Co <br />