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BUSINESS CERTIFICATE#08 (0 <br /> 7 <br /> • THE COMMONWEALTH OF MASSACHUSETTS <br /> TOWN OF MASHPEE (&'�j'/ <br /> DATE <br /> Expiration Dace: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 /> DBA K(/) )1-T$ `1' k A FT S is conducted at <br /> T <br /> Business Location: tkAt 1'C e.a, (p�°y $I56tkyNCAP& illia-(�nE 0A5ii?f& fi6A,�9 <br /> Business Mailing Address: t I <br /> Business Type:R E:�T A \ Business Telephone: �8 �'1-7 <br /> by the following named persons: <br /> G`/7JjIAFKL6-P <br /> NAME RESIDENCE <br /> S -IZFAL (00 F6UsS br, K4S}1PEFtKA 6AGr�{�1 <br /> Home Phone: <br /> I certify under the penalties of perjury that I,to the best of my knowledge and belief,have filed all state tax returns and paid all state <br /> taxes as required under law. <br /> *Signature of authorized agent *Signamre of authorized agent <br /> **Social Security Number(Voluntary) <br /> or Federal Identification Number <br /> In case of emergency <br /> N TELEPHONE NUMBER: <br /> Al+Cpany <br /> *This license will not be issued unless this certification is signed by applicant <br /> **Your social security number will be famished to the Massachusetts Department of Revenue to determine whether you have met rax filing or tax <br /> payment obligations. Licensees who fail to correct their non-fling or delinquency will he subject to license suspension or revocation. This request <br /> is made under the authority of Massachusetts General Law,Chapter 62C,Section 49p <br /> 77re Commonwealth of Massachuseas �j <br /> BARNSTABLE ss � / [) s b DATE �� <br /> Personally appeared before me the above-named�V�r y L' P F`�t`— and made oath that the foregoing statement is <br /> me. <br /> A certificate issued in accordance with this section shall be in force and effect for four yeas from the date of issue and shall be renewed <br /> each four s[hereaft so long as such business shah be conducted and shall lapse and be void unless so renewed. <br /> Signed <br /> Notary Pub 'c <br /> sFal Deborah F. Dari <br /> rt,a <br /> NOTARY PUBLIC Commission Expires: <br /> ItVIY��4$ <br /> Commonwealth of Massachusetts <br /> My Commission Expim July 24,2009 <br />