Laserfiche WebLink
r <br /> 74 <br /> ( BUSINESS CERTIFICATE# <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> • TOWN OF MASHPEE Are <br /> DATE <br /> Expiration Date: S/5 / <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 ofC. 1 <br /> . ..ot E-C-( rnDBA �&CV `�`l QU ��u G�4SS \ is Gconducted at <br /> Business Location: ,� w1\\--` Qe—ker MCLS M� p�� �C(- 04. co �'�-1 <br /> Business Mailing Address: <br /> '''nfft������ ��` <br /> Business Typ a 46 (�C.._(Y'.L C t `"r Business Telephone: <br /> Home Phone: <br /> by the following named persons: <br /> /' <br /> FULLNAME SIDENCE <br /> C� �.CIcJ N hC Bch. �d /YZ7 C ,il (.JWe l�/ P�A: <br /> 01 ac � Pie- M M 6 �csi <br /> 1 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 /> s as required under law. <br /> -Signature of authorized agent `Signature of authorized agent <br /> Ag°6- 1�1-- 7 <br /> `' Social Security Number(Voluntary) <br /> or Federal Identification Number <br /> In case of emergency <br /> NAME: 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 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 Common wealth of Massachusetts <br /> BARIN'STABLE ss DATE <br /> Personally appeared before me the above-named and made oath thattheforegoing 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 year reafier so Ion as such business shall be conducted and shall lapse and be void unless so renewed. <br /> t <br /> �ned <br /> Notary Public <br /> SEAL <br /> Commission Expires: <br />