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r- <br /> BUSINESS CERTIFICATE#08 f <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> • TOWN OF MASHPEE {c� <br /> DATE IJ <br /> Expiration Date: De ember 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 /> /p <br /> DBA elft is conducted at <br /> Business Location: u) t G ✓� a n�/ <br /> Business Mailing <br /> y,Address: <br /> tVt/ 57 (/. h t/l P eL ozo <br /> Business Type: ! rJkt� I t� U�0 /l� Jr't�,J siness Telephone: <br /> by the following named persons: l <br /> RESI NCE <br /> ,N r�J� 1W ��r�f'L(a_ ,� liar, tc�t; Q, DZI��S <br /> Home Phone:AML <br /> 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 /> as required un er law. <br /> *Signature of authorized agent *Signature of authorized 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 of Massachusetts <br /> BARNSTABLE ss // LL DATE ' <br /> Personally appeared before me the above-named V'r nCPh t• w r T 1 _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 y -s thereafter s long as such business shall be conducted and shall lapse and be void unless so renewed. <br /> 0ned <br /> Margaret C. Santos otaryPublic <br /> SEALo,y NOTARY PUBLIC <br /> (�f Commonwealth of Massachusetts 9-a Cj <br /> my Commission Expires Sept.24,2010 Commission Expires: <br />