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tr <br /> i <br /> BUSINESS CERTIFICATE#07 S� <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> • TOWN OF MASHPEE / <br /> DATE (!? ` �9'0:2 <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 a business under the title of <br /> vt <br /> k. <br /> A rlt _1 -D ,&VI QL Ce DBA is conducted at <br /> Business Location: mfA'—S <br /> Business Mailing Address: PprJ V Q W br, <br /> Business Type: Business Telephone: L1 �p'01- 99 <br /> by the following named persons: <br /> FULL NAME SIDENCE <br /> Cfi�� 1�f1 � (-1 i �nC�IJIQ r,,-)Y <br /> Home Phone: _Sbl-53144" <br /> I certify 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 /> Des as required under law. <br /> *Signature of authorized agent *Signature of authorized agent <br /> **Social Security Number(Voluntary) <br /> or Federal Identification Number <br /> In case of emergenev <br /> NAME: (k/I D( t� /� .���� jL TELEPHONE NUMBER: �J-)q'79�6 -b�7 <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 yoo,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 ofAlassachusetts <br /> BARNSTABLE ss � DATE (, -06- aCr_Q ebec c� �t en <br /> Personally appeared before me the above-named 5 n e 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 thereafter so long as such business shall be conducted and shall lapse and be void unless so renewed. _ <br /> igne9,KniJtrlt�4� <br /> _ rGl n Co '� <br /> Margaret C. Santos - ' `� Notary Public <br /> �Xt . NOTARY PUBLIC <br /> Commonwealth`of Massachusetts <br /> +' Ny Commission Expires Sept. Commission Expires: <br /> 24,2010 <br />