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BUSINESS CERTIFICATE# 10- CJd 4 <br /> THE COMMONWEALTH OF MASSA CRUSETTS <br /> • TO FI N OF MASHPEE <br /> DATE <br /> Expiration Date: December 31, 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 /> DBA is conducted at <br /> Business Location: <br /> cAU r Qu ti <br /> Business Mailing Address: c/ OO// ``// <br /> Business Type: I O Business Telephone box) 53/` e T[[��T y <br /> Home Phone( <br /> by the following named persons: <br /> FULL NAME RESIDENCE <br /> `�CA <br /> I certify under the enalues of perjury that I, to the best of my knowledge and b ief, have filed all state tax returns and paid all state <br /> Res a equine under <br /> / <br /> 'Sig ature of au 6e "Signature of authorized agent <br /> **Social Security Number(Voluntary) <br /> or Federal Identification Number <br /> / I In case of emergency ( r ry/y C <br /> NAME: ' V P)l.( /1'C."s TELEPHONE NUMBER( ,7u�� /// --6 9 <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 Commonwealth of Massachusetts BARt\'STABLE ss �(�) '1^J\ DATE <b/ , <br /> Personally appeared before me the above-named \f male V .�-�)w "i ' and made oath that the foregoing statement is <br /> true. <br /> .A-eertifto rued-in-accordance with this section shall be in force and effect for four years from the date of issue and shall be renewed <br /> eacl f iur years there a r so long as such usiness shall be conducted and shall lapse and be void un ss so renewed. <br /> Signed <br /> • Lon p Lary lic A <br /> SEA], WHY Pu Ile <br /> ' Cotnrncmroal. Q aasac use <br />