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BUSINESS CERTIFICATE#07- It <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> TOWN OF MASHPEE <br /> DATE h-IU— 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 /> undersigned hereby)declare(s) that <br /> —a business under the title of <br /> LP�1�I�q LAY 2L� DBA is conducted at <br /> Business Location: ` <br /> Business Mailing Address: <br /> Business Type: /4 ✓f e� et C�" Business Telephone: AJlh— <br /> by the following named persons: <br /> FUL NAMX_TRESIDENCE <br /> Home Phone:._ <br /> I certify under the penalties of perjury that I, to the best of my knowledee and belief, have filed all state tax returns and paid all state <br /> taxes as requir d under law. <br /> ignamre of authorized agent *Signature of authorized agent <br /> **Social Security Number(Voluntary) <br /> or Federal Identification Number <br /> In case of emergency <br /> NM <br /> AN 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 fumished to the Massachusetts Department of Revenue to determine whether you have met tax tiling 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 Afassachusetts <br /> BARNSTABLE ss / DATE /10j,007 <br /> Personally appeared before me the above-named C_ /4,04 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 /> Signed <br /> SEAL <br /> Notary Public <br /> I <br /> SEP L.M <br /> 111p 'pOpMMOM <br /> MyCmnnisBpn BON <br /> OgaOe 23,2043 <br />