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BUSINESS CERTIFICATE 1109 © 3 <br /> C0111MONFVEAL%'// OFMASSACl/USI TTS <br /> • %'011'1'OF MAS//P/'E <br /> DATE_ n•� _ 009. <br /> Expiration Date: DecensGeY 31, 20.73 <br /> In conformity with the provisions of Chapter one hundred and ten, Section live of the General Laws, as amended, the <br /> undersigned hereby declare(s) that a business under the title of <br /> vI3A f-v5ler9 �OIGt'S / � � is conducted at <br /> Business Location: LNKOU> iFDA--o DZ6Yl7'. <br /> Business Mailing Address: S''&.�N <br /> Business Type: i.c92- Business Telephone: 5-6 g -4 7 2-94? <br /> by the following named persons: <br /> FULL NAME_ RESIUENCL <br /> �O 5 !' e✓'t1�6 C-60G 2eb P <br /> I-tome Phone: .S06 77 6 - /.52CD - <br /> I certify under the penalties of perjurythat I, to the best of my knowledge and belief, have filed allstate tax returns and paid all state <br /> � � s as required under law. <br /> i,l rule of authorized agent *Signature of authorized agent <br /> pq 32-2& 35- <br /> **Social Security Number(Voluntary) - <br /> or Federal Identification Number <br /> ( In case of emergency - <br /> NAME I`L -CD B TELEPHONE NUMBER: ,�8 36 TJ <br /> ' TJ 7 <br /> Alarm Company: '/1CTo til ,tt1d.Kih eo , <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 cbhgatious. Liccescea who fail to cosec;tlteh 11011-Eking mdelinquency cil_be suhiect In license suspension or rerocatio!t. I'll is request <br /> is made under the authority of Massachuselts General I.,aw,Chapter 62C,Section 49A. <br /> The Commonwealth of Massachusetts - <br /> BA121VSTABLE ss DATE Oq <br /> Personally appeared before me the above-named � tJ -mil and made oath That the foregoing slateinenl is <br /> True. <br /> A certificate issued in accordance with this section shall be in force and effect for four years from the dale of issue and shall be renewed <br /> each four yea icreafIer so long cl business shall be conducted and shall lapse and be void unless so renewed. <br /> Sigurd <br /> • Deborah F. Darni a , <br /> NotP blit <br /> SEAL QWNOTARY PUBLIC - <br /> �y Commonwealth of Massachusetts <br /> My Commission Expires July 24,2009 commission f xpires: <br />