Laserfiche WebLink
BUSINESS CERTIFICATE# � <br /> r'HE-C-OAIrYlOV1 fFHAL-7H OFVYIASSMC-HUSET-T-S- <br /> TOPW OF MASHPEE <br /> DA'L'E " <br /> • Expiration Date: 3 a B <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 /> Business Name/DBA: 6AUWAOtut'A arts\ra 'b ov"Corporation Name: / ,1 is conducted at <br /> Business Location: A7 t,AWAR�tt I�PtA1F Vf gSffPEE A/�lc OL6 �N <br /> Business Mailing Address: t <br /> _',,as /aboy <br /> BusinessType:e """""'� lJ' Business Telephone: 50$- q77 - 64,Sll- <br /> Home Phone: 503 - 472 - (o654- Email Address: "ne cape c.od @ c ,a( - (?,Om <br /> by the following named persons: <br /> r1 <br /> Owner Name Owner Residence � <br /> Apoh. f Osie 6UGAS t� �/ARAA2M �Q'`'E • AASAPEE OZlofl9 <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 /> taxes as required under law. <br /> �wa A LwotA 0 Ve 3 B 9 7 <br /> jnature of authorized agen "Social Security Number(Voluntary) <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 /> NAME: 'qMW ��O TELEPHONE NUMBER: f08- y77 <br /> Alarm Company: <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 subiect to license suspension or revocation. This request <br /> is made under the authority of Massachusetts General Law,Chapter 62C,Section 49A. <br /> The Coutntomvealth ofAfassaelmsels <br /> BARNSTABLE ss DATE -9Z3 �e <br /> Personally appeared before me the above-named and made oath that the foregoing statement is <br /> true. <br /> A certificate issued in accordance with this section shall be in force and ifect for four years from the date of issue and shall be renewed <br /> each four years thereafter sos�o..long as such business shall be conducted and shall lapse and be void unless so renewed. - <br /> Signed_ / <br /> Notary Public <br /> • SEAL <br /> JO6EPF1k-M <br /> No Z?kssi5on_EEsp <br /> xpir <br /> COYMONWEALTN OF►USSIIptUiETb <br />