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BUSINESS CERTIFICATE#j63 <br /> TE/E COMMONWEALTH OF MASSACHUSETTS <br /> • TOWN OF MASFIPEE <br /> DATE-41/1/,20/0 <br /> Expiration Date: y [30 /doi� <br /> In conformity with the provisions of Chapter one hundred and ten, Section five of the General Laws, as amended, the <br /> undersigned heretbbyy declares) that a business under the title of /� <br /> Cnmf �IV[� DBA /�L"l�N 2cSP.�j�f7� is conducted at <br /> Business Location: I�� il��i!'�Z /A� /ti/0496Y� <br /> Business Mailing Address: 5AA& <br /> Business Type:C0423 / y Business Telephone: 77Y-7"-/969 <br /> Home Phone: sso; / <br /> by the following named persons: <br /> FULL NAME RESIDENCE <br /> 12!WA), - � � 3 Yui ir�p -►�!�—d /tP. <br /> vrZ <br /> I certify under the penalties of perjury that I, to the best of my knowledge and belief, have filed all st< ax returns and paid all state <br /> *, ,as <br /> r qu"ed under las <br /> '"S �i <ture of authorized ag *Signature a orized agent <br /> y 3- x©n 332 <br /> *"SoctalSecurity Number(Voluntary) <br /> or Federal Identification Number <br /> In case of emergency �/ <br /> NAA4E: ART/�i�!/7l ,/<D� TELEPHONENUMBER.7�/ <br /> i <br /> Alarm Company:. /Ms`yiV/i/ <br /> *This license will not be issued unless this certification is signet) 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 susnension or revocation. This request <br /> is made under the authority of Massachusetts General Law,Chapter 62C,Section 49A. <br /> The Commonwealth of Massachusetts n �/O <br /> BARNSTABLE ss ��yy''�� //���� /� /�^�. DATE <K <br /> Personally appeared befor above-namedlg /FC� - e)mo/G ci and made oath that t e foregoing statement is <br /> true. <br /> A certific issued in a c e 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 ereafter so tch business shall be conducted and shall lapse and be void unless so renewed. <br /> d ' \ <br /> *� =01 <br /> Notary Pu li r <br /> AMX <br /> SEAL �p1 CWd"W �.Elon J*2 <br /> Commission Expires: <br />