Laserfiche WebLink
r. <br /> BUSINESS CERTIFICATE#09-U <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> TOWN OF MASHPEE x�/O9 <br /> DATE <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 <br /> hereby dmlare(s)that a business under the title of 1 �! <br /> C/tl/ Y/neaaW //0 me Zoaru ,1 LLC DBA /'leICV0�rinan<ra� is conducted at <br /> Business Location: Wa✓T Oe., /1,1 /07,24 y9 <br /> Business Mailing Address: /01 /t'fa,�� Mg/ Nas�jQ?T�/�' 0°Z'Gyg <br /> Business Type: RCa�za�a�'t' /"ila7Ci_� Business Telephone: 7��r�- "1774300 0 <br /> by the following named persons: !/ <br /> FULL NAME _ RESIDENC�„4� <br /> rIan 7`•�d`�l/ �w,s /a7 Co;-dolA+�e. /,� <br /> /3y k /"IA oa06 <br /> Home Phone: 1P�7'J�97 �'�'7a7 <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 /> *Signature of authorized agent *Signature of authorized agent <br /> Z6- 3330q-& <br /> **Social Security Number(Voluntary) <br /> or Federal Identification Number <br /> !� In case of emergency <br /> NAME: VCt0.Y1 uv-Nis 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 subiect to license suspension or revocation. 'Ibis request <br /> is made under the authority of Massachusetts General Law,Chapter 62C,Section 49A. <br /> The Commonwealth of Massachusetts <br /> BARNSTABLEss DATE / <br /> Personally appeared before me the above-named 'bli'l O.h T,MOAAN/ LC IN t5 and made oath that the foregoing statement is <br /> true. <br /> A certificate issued in accordance with this tion shall be in force and effect for four years from the date of issue and shall be renewed <br /> each four years so long as s ch bu i ess s be conducted and shall lapse and be void unless so renewed. <br /> Signed ' <br /> {� t•4 .t Notary Public <br /> SEAL. ,r /`!!� • o <br /> —�sFT�Tn. 1�YM <br /> omnis on ,,,16,7 <br /> ^r <br />