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1 <br /> st fjo�wri o" <br /> VAP <br /> k' 5 TOWN OF MASHPEE <br /> 'nau�s co., <br /> Statement of Discontinuance,Change of Residence,Change of Location of Business, <br /> Withdrawal,or Deceased from Business or Partnership,Chan a of B siness Name or Owner Name <br /> �a <br /> _ 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 decAre(s) tha IWe as (have)1rs d y discontinued (retired <br /> from) (withdrawn from)the business of ` l�.o+ rod °I I V I` Lti <br /> conducted at —s I—i �-/% t�0 u)b M o <br /> STREET - <br /> , <br /> SIGNATURE <br /> Change of Location of Business . <br /> I hereby sYlte 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 /> SIGNATURE <br /> V✓ <br /> Change of Name of Business or Owner - <br /> I hereby state that the name of he business or the owner as it appears on the Business Certificate has <br /> been changed from a <br /> to <br /> SIGNATURE <br /> Notary <br /> Barnstable ss. <br /> Date <br /> Y appeared U f 4 iat�' .UJOL�-S�i <br /> Personall a eared before me the above named � and made oath <br /> • that the foregoing statements are true. <br /> N e&taM8ffit;L.MAT2lICCMEW, <br /> Notary Public <br /> C i PE Ou,�nTH 0. <br /> My Commission E»s <br /> Origibmi/Discontinuance - - OCIOM25 2D13 <br />