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BUSINESS CERTIFICATE#07 — q <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> • TOWN OF MASHPEE <br /> DATE �•Z. 07 <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 /> Linde ed hereby declare(s)that a business under the title of <br /> DBA <br /> ©� is .conducted at <br /> Business Location: <br /> Business Mailing Address: © -ez-� IeZS ts?oto Imss, c-)Zlo"1 7- <br /> Business <br /> Business Type: fj�7n�I? Business Telephone: �jQj- S� • oo7t� <br /> by the following named persons: <br /> FULL NAME RESIDENCE <br /> x S e:2 a �( ?0 fpO7 t2 ft_ ts-,,)chi I--1A•C24A <br /> � 121 Svc l��t� y- d=,'1� ozaol <br /> HomePhone: <br /> I ce un e ties of perjury that I, to the best of my knowledge and belief, have filed all state tax returns and paid all state <br /> re ed a law. <br /> *Signature o author ed agent *Signature of authorized agent <br /> 14-2• � <br /> **Social tecurity Number(Voluntary) <br /> or Federal Identification Number <br /> In case of emergency <br /> NAME: I �"T �N - / TELEPHONE NUMBER: -7 <br /> Alarm Company: <br /> - <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 D-C-0� <br /> onally appetite before t \' <br /> above-named \rN , A+ (1 h , e,t_ and made oath that the foregoing statement is <br /> true. Zi <br /> A certifica/ig�s e to cor nce 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 thpreaft to u business shall be conducted and shall lapse and be void unless so renewed. <br /> Si ned / Margaret C..Santos <br /> NOTARY PUBLIC I ) <br /> Commonwealth of Massachusetts <br /> AL 11yCommission Expires Sept.24,2010 otary Public <br /> n-i -a U- D01 O <br /> Commission Expires: <br />