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u BUSINESS CERTIFICATE # &1--D/� <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> TOWN OF MASHPEE <br /> DATE <br /> • Expiration Date: <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 Name/DBA: LG <br /> �C1t�.S Corporation Name: is conducted at <br /> q <br /> Business Location: 4 a7_\ G U is 1 %u Z Mfm n t4imy MN 07 264 9 <br /> Business Mailing Address: 14gkw\.% <br /> Business Type: N(%,%%. St1 Le N Business Telephone: 1� �//���� •s�� <br /> Home Phone: 617' 955` 2 22.1 Email Address: co!A f <br /> by the following named persons: <br /> Owner N me ONResiden£e <br /> �teQ �. ..Xr Llt� YKA <br /> oz \f1— <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 /> i 6924o23nca <br /> nature of au torize gent "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 /> "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 Commomvenith of Massachusetts <br /> BARt\`STABLE ss r ,N I DATE 2. 2. 200 <br /> Personally appeared before me the above-named F& Lt%r and made oath that the oregoing 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 e <br /> Notary Pub <br /> SEAL • . <br /> • DeboMh 08W Commission Expires: <br /> NOTARYPUSUC <br /> W QtlelfabeEghnJuly 29.2MG <br />