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BUSINESS CERTIFICATE#0700 <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> • TOWN OF M4SHPEE JUNE JU11 2007 <br /> DATE cy � <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 /> DBA EMLY M)CHK}EL. :MQ is conducted at <br /> Business Location: 76� O)QUTY RU00 I UT 7 mfg RPLE yVh PUy9 <br /> Business Mailing Address: <br /> Business Type: s►sIry e►�n /1 �g Business Telephone: 0�� <br /> by the following named persons: <br /> FULL NAME RESIDENCE <br /> 'fdYF.T('H► FISH�7P RonD�n► 96 C1�Wab OVENUE MASJIPELMVq <br /> Home Phone: <br /> certify under the penalties of perjury that I, to the best of my knowletip and belief,have filed all state tax returns and paid all state <br /> es as required under law. <br /> "Sig latt rofthorized agent "Signature of authorized agent <br /> "*Social Security Number(Voluntary) _ <br /> or Federal Identification Number <br /> In case of emergency <br /> NAME: TELEPHONE NUMBER: <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 tar filing or tar <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 /> BARINSTABLE ss DATE <br /> Personally appeared before me the above-named �Q i�1`�G%A� \1 C R,. and made oath that the foregoing statement is <br /> true. J <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 <br /> as such business shall be conducted and shall lapse and be void unless so renewed. <br /> ed <br /> VICKI ANN GOVONI <br /> - Nota TIM cublic <br /> SEAL - COMM TH OF MASSACHUSEM <br /> M1l Cp mesion Evwee <br />