Laserfiche WebLink
��:�o„•N of �j0� 0 3 a <br /> ' M <br /> TOWN OF MASHPEE <br /> ay.''°. zr .<,•�y� Statement of Discontinuance,Change of Residence, Change of Location of Business, <br /> %wi:c.co, Irawal, or Deceased from Business or Partnership, Change of Business Name or Owner Name <br /> DATE <br /> The Town is desirous of going "Green” as much as possible.To that end,please include your email address. <br /> Email Address: <br /> Discontinuance <br /> In conformity with the provisions of Chapter one hundred and ten, section five, of the General <br /> Laws, as amended, the undersigned hereby declare(s) that I/We has (have) this day discontinued (retired <br /> from) (withdrawn from) the business of <br /> conducted at <br /> STREET <br /> SIGNATURE <br /> Change of Location of Business - <br /> I hereby state that the location of the business/my residence as it appears on the Business Certificate filed <br /> on has been changed to <br /> • Name of Business - - <br /> SIGNATURE <br /> Change of Name of Business or Owner <br /> I hereby state that the name the busineess�s or the owner asitappears on the <br /> �Business <br /> 'C1eerti.�fi/catte�has <br /> been changed from VU— S ( l n/ I � h I�G�IJ ` 7 `�� ' <br /> to <br /> -� NATUZ n <br /> `i Notary - 2 D- ao i`7 <br /> Barnstable ss. <br /> Date <br /> Personally appeared before me the above named '^r rev l (�a L and made oath <br /> that the foregoing statements are true. ' <br /> . Notary Public vY cc u r e { <br /> ® monWealthofMargaret Santos Nam-Notary Public <br /> Commonivesllh of Massachusetts �- 2 a_ a �t, <br /> My commission Etipires on Sept.22,2017 <br /> Commission Expires <br /> Ori gforin/Discontinuance <br />