Laserfiche WebLink
BUSINESS CERTIFICATE# 10-50 <br /> n <br /> THE COMMONWEAL TH OF MASSACHUSETTS <br /> TO FVN OF MASHPEE 3 O <br /> DATE q <br /> Expiration Date: 3 3 T <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 ofI� LL <br /> $ ,n DBA/qS k a<YIQIJQ/L C D JJR47O✓tLT7 tfC conducted at <br /> Business Location: 10 ffl4*- WV1 MQSh dam, IA 10 <br /> 0279 <br /> Business ivlailing Address: 7.6 A6X A6 , MashTlaZLf /77/4 024+ Y9 <br /> Business Type: [_ Business Telephone: ('1;L-91)-,Q qq <br /> Home Phone: 5D$-g5'*-64055 <br /> by the following named persons: <br /> FULL NAME RESIDENCE 7 <br /> 2'JAiCGAR6T iQi95K%N /0 Ma v &J" lnwh IWA, M dzeaR <br /> I certify tinder 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 /> �axes as required under law. <br /> nyaw&":;� jej,. <br /> *Sign^ ahure of authorized agent *Signature of authorized agent <br /> ii 9-�8.3 Si 33 <br /> **Social Security Number(Voluntary) <br /> or Federal Identification Number <br /> In case of emergency <br /> NAME: eke k Rust r, TELEPHONE NUMBER417-686'1722. <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 \\\GK"C'T-VA �4S�Y� 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 v _ / <br /> Notary Public <br /> SEAT, VICKI AtN�yN72Or <br /> ct�dtlURi+f�lElll t0kMY CommieaAq 1B, <br />