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1 <br /> I <br /> BUSINESS CERTIt:ICATE N <br /> T/!E COMMONWEALTH OF MASSACHUSETTS <br /> • TOWN OF MASE/FEE DATE 3 a 11 <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 dcclare((s))that a business unnde�rr the <br /> ee(title of <br /> Business Name/DBA: �H�c/•1 UiR �TF `�C6rp oration Name: A-T /S is conduc�teed at <br /> Business Location: l.._0- <br /> Business Mailing Address: 1,4 Z4 <br /> Business Type: t // '/bne Business Telephone: <br /> Home Phone: ,'I (J 'T�� 'j"{f•:J� Email Address: <br /> by the following named persons: <br /> weer-PF a IC Owner Residence <br /> atz is tsi Ura L-� <br /> I certify under the penalties of perjury at 1, to the best of my knowledge and belief, have filed all state tax returns and paid all state <br /> to requir d u- er law. <br /> **Signature of authorized :e <br /> -@ Federal Identification Nu fiber <br /> 1. y <br /> 'This license will not be issued unless this certification is <br /> signed applicant <br /> In case of emergency <br /> 'I ' �— <br /> NAME: F"-d(? afZ t� 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 lax <br /> Payment obligations. Licensees who fail to correct their non-filing or delinquency will he subiecl to license susuension or revocation. This <br /> j request is made under the authority of Massachusetts General Law,Chapter 62C,Section 49A. <br /> The Cwtunonrvealth of Massachusetts <br /> BARNS'fABLE ss DATE 'a rC -,PO 1 � <br /> Personally appeared before me the above-named 6046il-r-t r and made oath that the foregoing statement <br /> Is IrtIC. <br /> A certificate issued in accordane vi th this section shall be in force and effect for four years from the dale of issue and shall•be renewed <br /> each four years thercaftSp7so long as su b sines shall be tducted and shall lapse and be void unless so renewed. <br /> Signe< <br /> otary Public <br /> • it Notary Public g - 3 a s ao Il <br /> Margaret C. Santos Commission Expires: <br /> CommomveaM of Massachusetts <br /> �M Commission res on Se .22,'17. <br />