Laserfiche WebLink
Qd <br /> BUSINESS CERTIFICATE# <br /> • THE COMMONWEALTH OF MASSACHUSETTS <br /> TOWN OF MASHPEE <br /> DATE .T&-14 <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: [�p�1p TO •t �� LLL Corporation Name: is conducted at <br /> Business Location: /O �3i_IA 04 Ji &Ak 1405t, " �e mil IA e -7. 'y<- <br /> Business Mailing Address: 5A.vvt2 e.4 a o U'- - <br /> Business Type: hh✓nn.ti LK2 iv l r r_e' Business Telephone: 7-7 <br /> Home PhEmail Address: A ovt 4gg4ta JQ&-je- •.CO-1y1 <br /> by the following named persons: <br /> Owner Name Owner Residence <br /> IlIU614 I✓IN,UO�L1 /D�15�n�n / e�L /fi�o4S�rn�el4 <br /> odcsy <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 r uired under la <br /> rgnature of uth zed 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 /> "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 <br /> request is made under the authority of Massachusetts General Law,Chapter 62C,Section 49A. . <br /> Tire Commonwealth of Massachusetts <br /> BARNSTABLE ss DATI J,"o lip t aOli <br /> Personally appeared before me the above-named4 ne A La't1'r-N and made oath that the foregoing statement <br /> is 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 t reafter so lonE as such smess shall be conducted and shall lapse and be void unless so renewed. <br /> S Gam- , d4�v-•1 <br /> �Q.(C71t.1.t� <br /> otary Public <br /> • SEAL <br /> q - as-a�17 <br /> ECW �a�ga'reta <br /> Noery,PublicCommission Expires: <br /> C.SantosoealM01Massachusetts <br /> nebn Irw on Se91.22 2017 <br />