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131JSINESSCERTIFICATE h09 (-)9` <br /> 771E COMMO.N6VEALTIJ OFMASSACJ-JUSETTS <br /> TO H'Af OF AIASIIPEE <br /> . llA"17: ?/d C ADO ry <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 /> - <br /> undersi med hereby declarc(s) that a business under the title of <br /> A� / bort — DBA _ is conducted at <br /> Business Location: � � �� �UNlll 4/-7 <br /> Business Mailing Addresss��://_,,,, <br /> Business Type: (C T{ Business Telephone: <br /> by the following named persons: - <br /> FULL NAME RESIDE. )E <br /> Ar <br /> Home Phone. <br /> I certify under the penalties of perjury that 1, to the best of my knowledge and belief, have fled all state tax returns and paid all state <br /> taxes as>qv7d under law. -� <br /> v <br /> tune of authorized agent email address <br /> �06 3-q y <br /> **S tial Security Number <br /> or Federal Identification Number <br /> In case of emergency <br /> NAME: TELEPHONE NUMBER: <br /> Alar Company: <br /> **Your social security number will be furnished to the Massachusetts Deparmnent of Revenue to determine whether you have met tax (ling 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 insole under the authority of Massachusetts General Law'Chaillter62C, aecdon 49F.. <br /> The Catunomvealth of Massachusetts <br /> BARNSTABLEss I DATE �J U <br /> Personally appeared before pre he above-named_ J J_ _Sit 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 fron the date of issue and shall be renewed <br /> -- eachfouryears Iliereafter so lonyg.�us suchbusiness shall-be conductedand sKSPI-lapse and-be vm-unless saleirewed. -- — ---- <br /> Signed / IS . <br /> J.l "`CCCJJJ""" <br /> otaraA`��`cB SCALLI <br /> SEAL NOTARY PUBLIC <br /> Convniss . s' es <br /> 9�4t W 2011 <br />