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BUSINESS CERTIFICATE # 09- <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> TOWN OF MASHPEE <br /> DATE b,���,s�r' t7-poi <br /> b0i <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 A, <br /> At t E„/ 6 a (V� DBA 'V AV JM C^,%. W a-sTS is conducted at <br /> Business Location: 1lU1 Ql 1'IK eta O <br /> °l S Sys' ,Gc.t_E SuorS6 ZL4 <br /> Business Mailing Address: q �uA1SET GtLc-cec kAS &%poe OWA 02Cacig <br /> Business Type Business Telephone: rl ' 4- 39 z• t oa17 <br /> by the following named persons: _ <br /> FULL NAME RESIDENCE <br /> A,Lmlo E t3A6& 3t suW sle i" Ciit C. MAiM4� WA <br /> Home Phone: +508- 5'3°t-2-9%1 d <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 re iced u er law. <br /> re o author agent *Signature of authorized agent <br /> **Social Security Number(Voluntary) <br /> or Federal Identification Number <br /> In case of emergency - <br /> NAME:At.`yam ZA(atS. CC' TELEPHONE NUMBERS60-0- S V1 2 914 0 <br /> Alarm Company: /V. <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 detemmine 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 G2C,Section 49A-_----- <br /> The Conunonwealth of Massachusetts (� Q <br /> BARIVSTABLE ss � "� DATE Q <br /> Personally appeared before me the above-named_&7 4"Oy Nt"''d--� '( and made oath that the foregoing statement is <br /> true. <br /> A certific e issued in accordance with this section shall be in force and effect for Cour years from the date of issue and shall be renewed <br /> each four years th after so long as such business shall be conducted and shall lapse and be void unless so renewed. <br /> Signed <br /> • . COMMONW fttlic R <br /> SEAL MV Comm"ssion E)Oms <br />