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BUSINESS CERTIFICATE# Q 0 d 78 <br /> 1 T-HE-C-ODIl6IOA''IYEA-L—TH-0"171 SSA't?HUSYI-I'S <br /> J <br /> TO IM OF MASHPEF_ <br /> DATE [to <br /> • Expiration'llate: ie) <br /> In conformity with the provisions of Chapter one hundred and ten, Section five of the General Laws, as amended, the <br /> undersigned hereby declar'e(s) that a business under the title of <br /> Business Namc/DBA: (V\xw o Corporation Name: is conducted at <br /> Business Location: n.a 1.y(�Q�IOh� �(_{� " t ' ` <br /> Business Mailing Ad re s: ��- t\QS�R�(IS )1 v"oul(kI <br /> Business Type: r ` nn Business Telephone: I,, (�J� ^�,�- <br /> Home Phone: ��� 26(I�1�� Email Address: �V�'/' J01"' U�k"�-"�^ <br /> by the following named persons: <br /> Own iIame(A nw-MW� _. , vner id�ncM <br /> I certify wider 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 /> taxes as req ired under law. <br /> gnaw of authorized went "Social SecuriryNumber(Vohmtary) <br /> or Federal Identification Number <br /> *This license will not be issued unless this certification is signed by applicant <br /> In case of emergency <br /> NAiME: TELEPHONE NUMBER: <br /> Alarm Company: <br /> **Your social security number will be furnished to the Massachusetts Department of Revenue to determine whether you have met tax fling 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 ofMassachuseus <br /> BARINSTABLE ss DATE J <br /> I <br /> Personally appeared before me the above-named ,' 4a,7 2. m tneCfnt?il 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, '^ <br /> 4 <br /> otary Public <br /> • L Margaret C. Santos <br /> NOTARY PUBLIC ay SIG <br /> Urrml)nweafth of Massachusells Commission Expires: <br /> Ny Commission Expires Sept.24,2010 <br /> I <br />