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BUSINESS CER'rIFICATE # <br /> THE COM0110ArIVEALTH OF MASSACHUSETTS <br /> TOWiV OF HASHPEE <br /> • DATE <br /> Expiration Date: �Ao d /r�,4f, <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 under the title of <br /> Business NanicfDBA: L RC'JMO�10tACorporation Name. is conducted at <br /> Business Location: L4 Gv 4; 1 e-V,%VN ells\2. r'ye- MnsLNo e e µ/1.- 02 6 4 4 <br /> Business Mailing Address: Sck t-Le. <br /> Business Type: HCIrNE IM V0VP_VIA ecA_ —Business Telephone: (Soso S66 )Z(��- <br /> Home Phone: (SoX 6$ R(,�Z Email Address: 1'�\w tsn�grAbOa3 COKCaS�. /d e+ <br /> by the following named persons: <br /> Owner Name Owner Residence <br /> t-ACL _7 4 _�.1va0. <br /> I certify under the penalties of perjury that I, to the best of my knowledee and belief, have filed all state tax returns and paid all state <br /> cases as required u�Iak - <br /> -4-S - 3f4,91z.S3 <br /> ignantre of autlt rt ed 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 /> LL 11 In case of emergency ��`` <br /> NAME: F_- eS-- co (AV-dz� NM <br /> TELEPHONEUBERksc:g) 6�'f.9 �g13 <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 Massachusetts General Law,Chapter 62C,Section 49A. <br /> The Coinino nnealth of Alassaclursetts <br /> BARNSTABLE ss , e', DATE <br /> Personally appeared before me the above-named Ik U-n� 6-i4� Bd Ar and made oath that the ongoing 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 <br /> • Notary Public K-- <br /> SEAL <br /> jjjk <br /> MO <br /> oman COMMONWEALTH OMy Care ftpola0or <br />