Laserfiche WebLink
• BUSINESS CERTIFICATE N��Z <br /> THE COMMONI VEA L TH OF MASSACHUSETTS <br /> TOWN OF MASHPEE <br /> DATE <br /> • Expiration Date: f !id <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 tinder the title of CA <br /> Business Name/DBA: tr <br /> C�- oration Name: �� C h'�.7tS�1 ThC i conducted at <br /> Business Location: q r�� <br /> Business Mailing Address: ✓) 1- V s <br /> �O v <br /> Business Type: wu�ti�r� Ql Gr-�I tl[�Business Telephone: .yam <br /> IIotne Phone:' O p G �01—� Email Address: )n �U 6A4V1��lr�� edm <br /> by the following named persons: <br /> Ownerl'ame ,� O�• cr Resider e �! O <br /> � >{7� c'� bdn h 1 ate•he lav s�I��rg �.o of y� \ <br /> ALAI L_0 'a v� 14 ROaS <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 /> W:namre of authori d 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 �/ <br /> NAME: 7q l C �l � � 1,L a:r rn TELEPHONE NUMBER,5 O / <br /> Alarm Company: <br /> "Your social security number will be furnished to the Massachusetts Department of Revenue to detennine 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 ofkfassachusells <br /> BARNSTABLE ss DATE <br /> Personally appeared before me the above-named OV3/4) X!::�'�?`� 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 years th after so long as such business shall be conducted and shall lapse and be void unless so renewed. <br /> Signed <br /> Notary Public <br /> SEALL.MUC CIELLI,JR <br /> NZ <br /> NOl 'es: <br /> COMMONWEALTH <br /> O TH 0 <br /> S',ppyapfCn DOM <br /> Of.InEr �. <br />