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BUSINESS CERTIFICATE#09-6 <br /> THE COMMOAUVEALTH OF MASSACHUSETTS <br /> TOTVN OF MASHPEF. <br /> • DATE <br /> Expiration Date: DeeenibeY 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 <br /> CO /N� <br /> 1� DBA�1 p&�\QFZ (?C� eld c)�S MC:P15 is conducted at <br /> Business Location: 2Z. 1n.k WnO :m �t`-� S\�\ 1 Y II> s RE M <br /> Business Mailing Address: �� ���'`D 2:0 �`(Ck�yJY ',, ',S �y t ISS <br /> Business Type:13;-�O�'K, C,W5 Business Telephone: <br /> VMe-lok54(-di-k.5 <br /> by the following named persons: <br /> FULL N E RESIDENCE <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 /> A�umlof authorrze7 gent *Signature of authorized agent <br /> **Social Security Number(Voluntary) - <br /> orFederalIdentificationNumber <br /> In case of emergency <br /> NAME: c��C� �__ 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 Commornvealth of Massachusetts <br /> BARNS'CABLE ss r/+ DATE <br /> Personally appeared before me the above-named tt r�.f Mey�6eS 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 Ion as such business shall be conducted and shall lapse and be void unless so renewed. <br /> Signed <br /> 0 r Margaret C. Santos Notary Public <br /> SEALQf� NOTARY PUBLIC <br /> �I( Commonwealth of Massachusetts 9—�y- a 0 f <br /> My Commission Expires Sept.24,2010 Commission Expires: <br />