Laserfiche WebLink
TOWN <br /> .... -..,..7.�-..�Or <br /> I <br /> qu TOWN OF MASHPEE <br /> •4yRe5� Statement of Discontinuance, Change of Residence, Change of Location of Business, . , <br /> Ys�;iipf co Irawal, or Deceased from Business m• 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 from) (withdrawn from) the business of 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 of the business or the owner as it appears on the Business Certificate has <br /> been changed from fa T�1� ��t I ' 1 . N <br /> to A,% io a iA IA <br /> SIG ATURE <br /> Notary <br /> Barnstable ss. � <br /> 1 Date <br /> Personally appeared before me the above named M ` 'h� �T ' h n and made oath <br /> that the foregoing statements are true. <br /> � Notery Public <br /> R Margaret C.Sflnt05 N,�,e-Notary Public <br /> 1 ComrriolrweslM at Massachusetts c=1 - !3'7 - 2� I <br /> \®�My�pmm pn E%pites on SBpL 22 201 Commission Expires <br /> Ori gform/Discontinuance <br />