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/Jt BUSINESS CERTIFICATE# �O1ti00 <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> T06VN 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 declauee(s) that a business under the title of <br /> Business Name/DBA: �- QST /� -S Ur—CCoorrporation Name: is conducted at <br /> Business Loca /;7tion: � rOP�y Pl&,ce. ��fj¢,r/� j� ��• az-16V9 <br /> Business Mailing Address: P�D/�6QX �/ ,/�,6,,f �/'�S�EF/�X10.4• '/0 Zj6 Vj <br /> Business"I'ypc: p "e —Z p CVO�t-/% s Business Telephone: r��`�� 7"7 7— 7Sb� <br /> Hoare Phone: J�0 ' 777— 7S2 Email Address: 45icAl : 600DG 17t© fb'1-Ak1G <br /> by the following named persons: <br /> Owner Name Owner Residence <br /> &OODE- /7 laoPOy Pkoce, t#45#1tCl 104, o26q . <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 /> mature 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 /> Lt case of emergency p / �,p <br /> NAME: �nn /C Q� TELEPHONE NTUMBER: SOW-0 70p�—�70 <br /> Alarm Company: Cot) 4L4RNI <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 Guuauunnealfh of Massachusetts <br /> BA12N'STABLE ss `` DATE 1 ' 09 - t�G 11 <br /> Personally appeared before nm the above-named c ' 12 h CoOtl e— 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 fiom 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 <br /> • Notary Public C J 'D, t <br /> Margaret C.Santos Commission Expires: <br /> Commomeeallh of Massechuseta <br /> 15)my Commission Expires on Sept.22,2017 <br />