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BUSINESS CERTIFICATE 4 08 •-S7 <br /> • THE COMMONWEALTH OF MASSACHUSETTS <br /> TOWN OF MASHPEE / <br /> DATE S 9 ©� <br /> Expiration Date: December 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 /> T(7e <br /> 0,U0k\L -f �aly\kSCrll e DBA is conducted at <br /> Business Location: �� �^{�s��tC7t]�� �(Z.� Wr� `Z N7 <br /> Business Mailing Address: <br /> Business Type: lc�(t)GkS ccte c Business Telephone: <br /> by the following named persons: <br /> FULL NAME RESIDENCE <br /> Home Phone: -a-CA `-{(Z 6 <br /> Aakertify under the penalties of perjury that 1, to the best of my knowledge and belief, have filed all state tax returns and paid all state <br /> s as required under law. <br /> *Signature of authorized agent *Signature of agent <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 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 ofMassachasetts <br /> BARNSTABLE ss DATE ?S'-(p• �� <br /> Personally appeared before me the above-named �?)d en ift L4`m�be 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 /> �ed <br /> Q,A Margaret C. Santos <br /> NOTARY PUBLIC Notary Public <br /> Commonwealth of Massachusetts <br /> SEAL Ny Commission Expires Sept.24,2010 4- 'Q V_')U f 0 <br /> Commission Expires: <br />