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— BUSINESS CERTIFICATE# 08 <br /> • THE COMMOAJ VEAL TH OF MASSACIIUSETTS <br /> TOWN OF MASHPEE s {� <br /> DATE <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 /> / G_'. /NC. <br /> �GU.tZ4utFEAT/JQCOD'CirJ5 - DBA is conducted at <br /> Business Location: CS d tj !J d/oJ /2'r <br /> Business Mailing 0 D Address: / /ZG� 7��/ ��1_S-7-eW_5 A4`"LLst )1114 ' crd6 yo' <br /> Business Type: ��//� C /� GIJ Business Telephone: —.�� / —��� 7 <br /> by the following named persons: <br /> /1 FULL NAME RESIDEENCE <br /> Glue /L/ Cf.10 �C AI LL,44 <br /> HomePlrone: ZJ 1d(?- 10'7-7 <br /> IVertrfy 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 /> es as r aired under law. <br /> / <br /> *Signature of autl ized agent - *Signature of authorized agent <br /> UiD - sN-iq3 8 <br /> **Social Security Number(Voluntary) <br /> orFederalIdentification 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 susnension or revocation. This request <br /> is made under the authority of Massachusetts General Law,Chapter 62C, Section 49A. <br /> The Commoinvealth 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 /> Notary Public <br /> SEAL <br /> Commission Expires: <br />