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BUSINESS CERTIFICATE#06L-_L( <br /> THE COMMONWEALTH OFMASSACHUSETTS 1 <br /> • TOWNOFMASHPEE DATE Y/� Qy' \ <br /> Expiration pate: December 31, 20101 <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)thatt�a business under the title of <br /> AAcb� C\h2M^ -«- r�"t v"A�StN. DBA is conducted at <br /> i <br /> Business Location: <br /> Business Mailing Address: ZZ 114- N',c4S�,Pe..2 N�f C O atop{q <br /> Business Type: Business Telephone: `J D • ��2 • <br /> fie /- <br /> by the following named persons: S�S fe M <br /> RESIDENCE <br /> rJN ! <br /> CA vim— �� .�i rtisk \ l cwt C_1- k Mas1`rxe M Aa-b'�R <br /> r <br /> 0-414,19'V\ SwwA\ ! Z41 l,JL>oAwtAA<_ Ck Wa �1WllALC <br /> Home Phone: <br /> I Instlify undeLAht penalties of perjury that I, to the best of my knowledge and belief, have fWed all state tax returns and paid all state <br /> taxe a it d de <br /> 19=15i o f authorized agent """OtOe of authorized agent <br /> lS(c� S20 <br /> **Social curity Number(Voluntary) <br /> or Federal Identification Number <br /> \ c In case of emergency I <br /> NAME: J o^1 5 CM Sat,` TELEPHONE NUMBER: mak%•44.4S <br /> *This license will not 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 tax <br /> payment obligations. Licensees who fail to correct their non-filing or delinquency will be subject to license suspension or revocation. This <br /> request is made under the authority of Massachusetts Gerieral Law,Chapter 62C,Section 49A. <br /> The Commonwealth of Maigachuseta <br /> BARNSTABLE ss DATE, 2?,f C I 200 <br /> i <br /> Personally appeared before me the above-named t5`rt and made oath that the foregoing statement is <br /> true. 4 <br /> A ertificate . ue in a cordance with this section shall be in force and effect for four years from the date of issue and shall be renewed <br /> each four ye Cher er Ion as c iness shall be conducted and shall lapse and be void unless so renewed. <br /> Signed <br /> • �,, Notary Pu he <br /> SE <br /> _ Deborah F. Dami <br /> 4h C NOTARY PUBLIC Commission Expires: <br /> ( Commonwealth of Massachusetts <br /> 'res July24,2009 <br /> .. 't. My Commission Expi <br />