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BUSINESS CERTIFICATE#09- U <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> TOWN OF MASHPEE I <br /> . DATE �U\ <br /> Expiration Date: December 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 declare(s)that a business under the title of c, Q n <br /> VL �A(�heap �ef� CCf iC rQ tt p '. ,DBA \Ag cl r Y1 .1�71C.P \ (Je P.is conducted at <br /> Business Location: ` oi, IU0.+y)CXT1 E1At•� <br /> Business Mailing Address: <br /> t_ ' I t� Q r� - <br /> Business Type: Cci( c"�Q. (1n Business Telephone: �1CA al Ma <br /> ��nnbb/y the following named persons: /n� <br /> II IkC IJL4 C E a 1 <br /> Home Phone: I M <br /> I rtify 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 /> s as required un er lay. ^ _ <br /> i <br /> Signature of authorized age *Signature of authorized agent <br /> so—n43c Q I �9 <br /> **Social Security Number(Voluntary) <br /> or Federal Identification Number <br /> I� �,,M (\��', In case of emergency <br /> NAME 11CI IYLF�I'e—Me-L.rO, 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 /> r`� <br /> Personally appeared before me the above-named Kt�C��Ht�Y (__12_�` and made oath that the foregoing statement is <br /> tme. <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 <br /> /thereafter so long as <br /> such business shall be conducted and shall lapse and be void unless so renewed. <br /> Signed �j <br /> Marw <br /> otary Public <br /> SEAL- ISI Q'✓'� bi �'f�� . <br /> t <br /> Commission Expires: <br />