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BUSINESS CERTIFICATE # 10-61 <br /> THE COt1fMOiVFVEALTIIOF NIASSACHUSE'TTS <br /> • TO PVN OF MASHME <br /> DATE l '1 <br /> la <br /> lok'f3v <br /> Expiration Date: Dceember i�tr 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 /> H erl ry ''11f,t_ nuU n V1 DBA ) la On It is conducted at <br /> Business Location: W Fal wool Vu 6?j-)J ypliCQ MUS�t r>2e tt 1 A (2 26 t-I q <br /> Business Mailing Address: (o&I F;Q_J ou`f4, rcletd � Naa 12—ce (14 0244 <br /> Business Type: wod i I S�oti Business Telephone: <br /> by the following named persons: <br /> FULL NAME RESIDENCE <br /> 2S9 4)nc3 Pond bftv2 <br /> Ne>lrtn 11; P HtAtlnti �ywt� y avmuwf I t� ntA oa 66y <br /> Home Phone: 5N "acl2-$'27of Email Address: If PT-19006 7a-Ao0- C1r),vt <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 /> Des as required under law. <br /> *Signature of authorized agent email address <br /> op-q& - 92473 <br /> "Social Security Number <br /> or Federal Identification Number <br /> II__ In case of emergency <br /> NAME: Pb i h e 4tA t4i roll TELEPHONE t t ER: <br /> Alarm Company: <br /> "Your social security number will be furnished to the Massachusetts Department of Revenue to determine whether you have met tar 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 /> BAitt\'STABLE ss DATE t ! 90/0 <br /> Personally appeared before me the above-namedand made oath that the foregoing statement is <br /> true. <br /> A certificate issued in accordance with this section shall b in for a and a ect for four years from the date of issue and shall be renewed <br /> each four years thea ft so Ion as such business shall be conducted and shall lapse and be void unless so renewed. <br /> Signed \ <br /> Notary <br /> a3 <br /> aMargaret-C. Santos Notary Public <br /> SEAL ttiq NOTARY PUBLIC C)-�y _ ado <br /> Commonwealth of MBSS3ChU5etIS Commission Expires: <br /> �� <br /> My Commission Expires Sept.24,2010 <br />