Laserfiche WebLink
BUSINESS CERTIFICATE /O <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> • TOWN OF MASHPEE <br /> DATEITI Z.10 <br /> Expiration Date: <br /> In conformity with the provisions of Chapter one hundred and ten, Section rive of the General Laws, as amended, the <br /> undersigned hereby declare(s)that a`business under the title of I ,\Ib <br /> DBA �(� 44 wt� \YO xCt4 �Ql1 <br /> ml is conducted at <br /> Business Location: rL f�� C ' le w� r^k//��0CP�2 j q9 <br /> Business Mailing Address: R rkirof\l CirC� Ut'Ia k1woenet.,� MIA OZb t <br /> Business Type: Mt, 1_rvvnrbvc,,,w..T Business Telephone: brl / S96— IOS� <br /> Home Phone: 508.1 yj9 — J.�,-7 Z <br /> by the following named persons: <br /> FULL NAM RESIN <br /> B ch,& DECc, Ct Ma";V,W ,Vn1' 6_1649 <br /> I certify under the penalt es of perjury that I, to the best of my knowledge and belief, have filed all state tax returns and paid all state <br /> taxes4red un�er la�thorized agent *Signature of authorized agent <br /> "Social Security Number(Voluntary) <br /> or Federal Identification Number <br /> 1 \ In case of emergency <br /> NAME: M)�,& �TS TELEPHONE NUMBER: 617 S56 — ILII <br /> Alarm Company: <br /> 'This license will not be issued unless this certification is signed by applicant <br /> "Your social security number will be famished 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 p <br /> BARNSTABLE ss � DATE Ib-2 Pj ' Ze IO <br /> Personally appeared before me the above-named I\N4 1n 1J• c - , and made oath that the foregoing statement is <br /> true. <br /> A cervi ficat ' sued in a cordance 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 Chef r so I t such buiness shall be conducted and shall lapse and be void unless so renewed. <br /> Signed <br /> Notary Pub <br /> • SEAL Deborah DOyd <br /> NOTARY Pfd ,J Commission Expires: <br /> tljCatEon 6. <br />