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2009
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Last modified
11/11/2017 3:50:23 AM
Creation date
11/13/2016 10:16:31 PM
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Box 038
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�s <br /> BUSINESS CERTIFICATE# 10-fib <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> • TOWN OF MASHPEE <br /> DATE <br /> Expiration Date: December 31, 2014 <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 /> '5fcx � A�+57 1 J;55L't DBA RAt¢4,S 4JI> 3Vt3F>C.ES is conducted at <br /> Business Location: U N t Z CJS So�T}i gT. n NF1 P� t AAN 0_10`5 <br /> Business Mailing Address: Pn 30X tio3 f:bz TA4L-E , /tM4 C-ZX04`"i <br /> vpv P. <br /> Business Type: DOso acxl-1QqE1_(oZODM Business Telephone:C-WD) &05- (40-7 <br /> w-(�) ylei- -1`13y <br /> Home Phone: riD� - 4'ZO- O"�-o17 <br /> by the following named persons: <br /> FULL NAME RESIDENCE <br /> �3sF-F�5o,, DE (-e-0,J -L—I etxq Dev_Av" WV" Sa�011_AC- 4,AA <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 /> as required under law. <br /> `Signature of authorized agent *Signature of authorized agent <br /> "Social Security Number(Voluntary) <br /> or Federal Identification Number <br /> In case of emergency <br /> NAME: M6t_I&)C>A &ALtAS /PA4U i, ndac�r�,Z TELEPHONE NUMBER(9iO$) -7-7(0' _-S30 <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 Commonwealth of Massachusetts <br /> BARNSTABLE ss DATE O <br /> Personally appeared before me the above-named !S rn �_POn 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 long as such business shall be conducted and shall lapse and be void unless so renewed. <br /> ed <br /> ret C. Santos <br /> NOTARY PUBLIC <br /> J Notary Public <br /> SEAL Commonwealth of Massachusetts <br /> My Commission Expires Sept.24,2010 t? —meq —oZO V <br /> ttommission Expires: <br />
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