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BUSINESS CERTIFICATE#9(f <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> TOWN OF MASHPEE <br /> DATE <br /> ii <br /> Expiration Date: 1 2 3 <br /> In conformity with the provisions of Chapter one hundred and len, Section five of the General Laws, as amended, the <br /> undersigned hereby declare(s)that a business under the title of <br /> 1'e�uSeM �+ re5.e� IZvte-. DBA t.r tm4c, K1 is conducted at <br /> Business Location: 10(o CX63 mai Fl`+ Qd c�d1 Sh e O a Ce�9 <br /> Business Mailing Address: t 00 Tc�e r-5 i re- (l e'6W4 AP....)5 \/A 2-3 U C 2 <br /> Business Type: + 4 Business Telephone: <br /> —V -K-v, 5� —#Ui_� <br /> Home Phone: <br /> 90 <br /> IL 4i t r_. <br /> by the following named persons: <br /> i <br /> FULL NAME RESIDENC�. k �� Z <br /> F�ray.simtzci ..S <br /> = v.erSt2 lasoOeffersvrs r1`al r 3 0o`Z <br /> I certify under the penalties of perjury tat I, to the best of my knowledge and belief, have filed all state tax returns and paid all state <br /> es equ V6qV1aw. <br /> xz <br /> t atur f authorized agent -C�c-4 )1-15k.�jee , *Signature of authorized agent <br /> * ) <br /> or Federal Identification Number <br /> In case of emergency <br /> NAME: TELEPHONE NUMBER: <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 BARNSTABLE ss DATE to' LI 'I � <br /> Personally appeared before me the above-named S-11tlVCJ. {NALe-C. R'5 <br /> ,_6lt.. "and made oath that the foregoing statement is <br /> We. �INo"JY <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 thereafter so long as such business shall be conducted and shall lapse and be void unless so renewed. <br /> Signed xxttttluuurrr ' <br /> 14 y 'M. A V Ll III , I <br /> '4 6'.L Notary Public <br /> SEAL _ .P;20 MY - <br /> COMMISSION <br /> NUMBER :Q Commission Expires: <br /> 7276855 �2,= <br /> �X <br /> "''�AL'TH1�F��. <br />