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_--- —— BUSINESS CERTIFICATE#08-L43 <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> TOWN OF MASFIPEE <br /> DATE <br /> Expiration Date: DeCemheP 31, 2012 <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 /> is conducted at <br /> I � <br /> vvts or J <br /> Business Location: 31 QuA k rlef Rd Ka-14 t+oo MA e926Yj <br /> Business Mailing Address:: S "irk a-4— <br /> Business Type: Farm 7 4L her Business Telephone: <br /> by the following named persons: <br /> FULL NAME RESIDENCE <br /> In( Me 31 qua /lArf_ i�rc( �MAStIPFF <br /> Home Phone: <br /> �ertify Under the penalties of perjury that I, to the best of my knowledge and belief, have filed all state fax returns and paid all state <br /> Wes as required under law. <br /> * t nature f ant orize agent *Signature of authorized agent <br /> **Social Security Number(Voluntary) - <br /> or Federal Identification Number <br /> In case of emergency <br /> 509)477-9'63}° <br /> NAME: Ukom "y1 TELEPHONE NUMBER: e —7 <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 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 <br /> Personally appeared before me the above-named 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 yea thereafter so long as such business shall be conducted and shall lapse and be void unless so renewed. <br /> �ned o <br /> Notary Public <br /> SEAL <br /> Commission Expires: <br />