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BUSINESS CERTIFICATE#07 — I I S� <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> TOWiV OF[YIASHPEE <br /> DATE <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 /> u/nJdersigned hereby declare(s) that a business under the title of <br /> C/hu'�"E✓ >>e /<CiG ti :IM DBA is conducted at <br /> Business Location: !��^ �` pp��q <br /> Business Mailing Address: OtUr �e l O Z <br /> Business Type: ��r✓ �, i,C Business Telephone: <br /> by the the following named persons: <br /> FULL NAME <br /> rrr,l �/� C 7IDENCE1 <br /> amici :/7 � <br /> �} 1eI.rS4o�� <br /> Home Phone: / <br /> ��� S�9 �6J �� <br /> I certify under the penalties of perju that I, to the best of my knowledge and belief, have tiled all state tax returns and paid all state <br /> taxes as re uired nder I - <br /> i_nature of authorized agent *Signature of authorized agent <br /> -Zi'? ''2 61p_� <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 willnot be issued unless this certification is signed by applicant <br /> "Your social security number will be famished to the Massachusetts Department of Revenue to determine whether you have met tax filing or tan <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<Vassachusetts <br /> BARNSTABLE ss o DATE <br /> Personally appeared before me the above-named (Y--)t"7f%r�ec,0 JcAli i VQand 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 tour years th— such busi a eco to and shall lapse and be void unless so renewed. <br /> Signed <br /> • SEAL Margaret C. Santos otary Public <br /> . NOTARY PUBLIC <br /> Commonweallh of Massachusetts Commission Expires: <br /> wwy <br /> Commission Expires Sept.24,2010 <br />