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BUSINESS CERTIFICATE#09 <br /> 7HE COMMONWEALTH OF MASSACHUSETTS <br /> TOWN OF MASHPEE <br /> DATE <br /> Expiration Da e: DeCei92ber 31, 2013 <br /> In conformity with the provisions of Chapter one hundred and ten, Section five of the General Laws, as amended, the <br /> undersigned hereby declaie(s)that a business under the title of <br /> n t <br /> Q(p4/s DBA �„JPdG1�{•�t,� t�/✓/(�'luoc�eed/id�-f is conducted at . <br /> Business Location: 7 nG Lt�Y�� n ffaii'G-61�� 2* <br /> Business Mailing Address: <br /> Business Type: Business Telephone: <br /> by the following trained persons: <br /> ULL N ME / RESIDEN E <br /> Awer. Z2 <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 /> ature of authorized a - t email address <br /> "Social Security Number <br /> or Federal Identification Number <br /> In case of emergency �- <br /> NAME: 4il�1t,-OL TELEPHONE NUMBER: y0y/ <br /> Alarm Company: <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 / n <br /> BARNSTABLE ss DATE 0L( V <br /> Personally appeared before me the above-named /vr/(' 4 t� ill 1 �r�/ S 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 yearrss/theereaftei so long as such business shall be conducted and shall lapse and be void unless so renewed. <br /> Signed <br /> SEAL <br /> Deborah F. Dam n Lary Publi` <br /> NOTARY PUBLIC <br /> commonwealth atMassachuse Commission Expires: <br /> My Commission Expires July 24,2009 <br />