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old - G23/ <br /> p'IO�I_N OF <br /> TOWN OF MASHPEE <br /> c Statement of Discontinuance,Change of Residence,Change of Location of Business, <br /> Withdrawal,or Deceased from Business or Partnership, Change of Business Na a or Owner Name <br /> DAYE <br /> The Town is desirous of going"Green" as much as possible. To that end, please include your email address. <br /> Email Address: <br /> Discontinuance <br /> In conformity with the provisions of Chapter one hundred and ten, section five, of the General <br /> Laws, as amended, the undersigned hereby �ecl�re(s) that 1/�! has (have) this day discontinued (retired <br /> from)(withdrawn from) the business of VMS, O Y� `C���' s le, <br /> (!%A <br /> conducted at <br /> STREET <br /> SIGNATURE <br /> Change of Location of Business <br /> I hereby state that the location of the business/my residence as it appears on the Business Certificate filed <br /> on has been changed to <br /> � Name of Business <br /> SIGNATURE <br /> Change of Name of Business or Owner <br /> j I hereby state that the name of the business or the owner as it appears on the Business Certificate has <br /> been changed from <br /> to <br /> SIGNATURE <br /> Notary <br /> Barnstable ss. <br /> Date <br /> Personally appeared before me the above named and made oath <br /> that the foregoing statements are true. <br /> • Name-Notary Public <br /> Commission Expires <br /> Origfonn/Discontinuance <br />