Laserfiche WebLink
BUSINESS CERTIFICATE# 10-r_.) (4a— <br /> THE COMMONWEALTH OF MASSACRUSETTS <br /> • TO IVN OF MASHPEE <br /> DATE Z��� <br /> Expiration Date: DCCB!)tber 31, <br /> act 3 <br /> In conformity with the provisions of Chapter one hundred and ten, Section five of the General Laws, as amended, the <br /> undersigned he eby declare(s)that a business under the title of n Ta y t <br /> DBA��/ is conducted at <br /> Business Location: 7 Q /i1/ <br /> Business Mailing Address: <br /> Business Type: b^J"�`Y �' %o-f'to' Business Telephone:/Lj/ <br /> i <br /> Home Phone: / -Z Z/? <br /> by the following named persons: <br /> FULL NAME ` RESIDENCE <br /> I certify under the penalties of perjury that I, to the best of my knowledge and belief,have file all state tax returns and paid all state <br /> 40axes as required under law. <br /> "Signature of authorized agent "Signature thorized agent <br /> **Social Security Number(Voluntary) <br /> or Federal Identification Number <br /> In case of emergency <br /> NAME: ALG} 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 fumished 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 <br /> Personally appeared before me the above-named 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 /> •Signed <br /> Notary Public <br /> SEAL <br /> Commission Expires: <br />