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BUSINESS CERTIFICATE #08 <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> • T0I41N OF MASHPEE / L7 <br /> DATE 'y •/(y L)U <br /> Expiration Date: Deeembel" 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 /> ,L5V--' Ke-)A/ 10/36 �d���� S �p <br /> DBA is conducted at <br /> Business Location: <br /> Business Mailing Address: -70 C "CT-E)e 61 • 81L4 N- W 5 /U64 6.-J-PiOO <br /> Business Type: .e ))e_119 Business Telephone: 77�9 )'- -766Y <br /> by the following named persons: <br /> FULL <br /> 5 I'1i1 lNAME6�Du�N RESIDENCE <br /> T12 }V1af3 N�. iar��-n/v Lc�t�`I <br /> �p <br /> Home Phone: `Z - ?jiP cl'"O J�J�t7 <br /> Aakertify 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 regquuired 40dei law. <br /> *Signatureauthorizer�t *Signature of authorized agent <br /> 0/ (P-0/ U319 J <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 Caanaiaanvealth ofMassaehusetts . - d <br /> BARNSTABLE ss DATE <br /> Personally appeared before me the above-named C 1-Y /1/ Y U'`�f and made oath that the foregoing statement is <br /> it <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 thereafb_ so long as such business shall be conducted and shall lapse and be void unless so renewed. <br /> ed <br /> . SEAL , <br /> . ELU, <br /> , Notary Public <br /> 18A es. <br /> OcWw 25.2013 <br />