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BUSINESS CERTIFICATE#08 <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> • TOWN OF MASHPEE <br /> DATE W <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 /, 'LlA .y <br /> 1 DBA 12nh IS is conducted at <br /> Business Location: !� � <br /> Business Mailing Address: .S AI 4 l j� i Or Q� / (� <br /> Business Type: Business Telephone: 77q -d ��7 D N <br /> by the following named persons: <br /> FULL NIVIE RES DENCE <br /> Home Phone: 7 7 q <br /> I certify under the penalties of perjury that I, to the best of my knowledee and belief, have filed all state tax returns and paid all state <br /> t111A, -A-a, s as reired andAr la^w. <br /> � t <br /> Sig authorizedn re of authorized Aent *Sig-n-atu/1 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 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 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 years thereafter so long as such business shall be conducted and shall lapse and be void unless so renewed. <br /> ((J <br /> Signed <br /> • rvvt r� /(l/ <br /> o c <br /> SEAL JOSEPH L.MAllLI=ELU,JN <br /> I(ICOMMONWEALTIC6Et1tUd9}� <br /> My Cornmission Expires <br /> �� Obobrg25,2013 , <br />