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BUSINESS CERTIFICATE# /CJ"l03 <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> TOWN OF MASHPEE <br /> DATE � � — /C) <br /> Expiration Date: 3 <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 as business under the title of �/ <br /> Business Name/DBA:�y7d 1 tw t e r MelKCorpora1tiion Name: / G 1 d�/F �� i�L`onducted a[ <br /> Business Location: / / e '' t "e <br /> Business Mailing Address: 7 <br /> Business Type: r'lop [�� �2 �J�'✓ flD yP/f3j;- - Business Telephone SV5 `l77 0 17y � /ad <br /> Home Phone: DO 0 ' '1(77 Email Address: 1.;7_,'4 / C 6 f /ueJ C-, �t1 <br /> by the following named persons: <br /> Owner Name . Owner Residence <br /> 3-'q S .S /O�v r <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 /> ANIL <br /> gnature 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 <br /> NAME: TELEPHONE NUMBER: <br /> Alarm Company: <br /> i <br /> ••Your social security number will be fumished to the Massachusetts Department of Revenue to determine whether you have met taxfiling 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 /> I <br /> The Commonwealth of Massachusetts _ aa <br /> BARNSTABLE ss /t DATE <br /> VAU <br /> Personally appeared before me the above-named -mr: S S721wat- 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 thereafter so long as such business shall be conducted and shall lapse and be void unless so renewed. <br /> Signed , S <br /> Notary Public _ <br /> SEAL �r <br /> i1 JOSEPHL M�f71 <br /> CorgtvJ§s wiExpires:� <br /> 00YMONWF-ALTN OF MASgAOtryICETn <br /> '25.2D13 <br />