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1 BUSINESS CERTIFICATE# <br /> THE COMMOA'IVEALTII OF MASSACHUSETTS <br /> TO II/N OF MASLIPEE _ 0 <br /> DATE <br /> Expiration Date: ��-J oT! k( <br /> In conformity with the provisions of Chapter one hundred and ten, Section five of the General Laws, as amended, the <br /> undersigned hereby declaarree((ss)-pthat a business under the title of <br /> Business \'am \lfn <br /> e/DBA: y( �(" r Il.l-11 Corporation Name: J is conducted at <br /> Business Location: ��I.J�J1�- 1� 1 on it � F) HAPS ) t�f 0L(D"4J <br /> Business Mailing Address: �Iak4_t tom?`�q n p <br /> Business Type: <br /> /1dcuicky Business Telephone: ✓(�/C��l L J haqw,t��t// �p <br /> Home Phone: �IUI L1� 0� 1 Email Address:&C/0 C A/1/9) f�D/ MJ1t1Z1 <br /> by the following named persons: �%� Y 1 1 n <br /> 20 <br /> A �C`�cr\r\1'I � MCi(\ S� IJIIIIH� st1cC� (�(� "II\ <br /> M 1 PQ MA Q_LU u 2 <br /> I certify under the penalties of perjury that 1, 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 /> D/a coy 9pso <br /> *Signature of authorized agent "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 /-(gyp p <br /> NAME: &_ t� �/ yt°e TELEPHONE NUMBER: (%/0 <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 subject to license suspension or revocation. This request <br /> is made under the authority of Nlassachusens General Law,Chapter G?C, Section 49A. <br /> The Commonwealth ofHassaehusetts <br /> BARTt\'S'CABLE ss DATE <br /> Personally appeared before me the above-named\ C?��'`��ei0 ��w�l�f1V� 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 yeaarrss/t'h�e1reaafte'i(so�long as such business shall be conducted and shall lapse and be void unless so renewed. <br /> Signed \.{.Jly- It l./�lA /� ��C/I��''��17 •�(� <br /> Notary Public <br /> SEAL <br /> q� VICIO=MASSACKUSETfl <br /> NCOMMONWFotdy(.�OA <br />