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�yV <br /> BUSINESS CERTIFICATE# -; JI i —(7 33 <br /> • THE COMMONWEALTH OF MASSACHUSETTS <br /> TOWN OF MASHPEE <br /> DATE <br /> Expiration Date: a <br /> In conformity with the provisions of Chapter one hundred and ten, Section five of the General Laws, as amended, the <br /> undersigned hereby declares)that:t business under the title of <br /> Business Nanie/DBA: Leasing Services Corporation Name: is conducted at <br /> Business Location: 63 Greensward Road Mashpee MA 02649 <br /> Business Mailing Address: 63 Greensward Road Mashpee MA 02649 <br /> Business Type: Equipment Financing Business"Telephone: 508-539-2310 <br /> home Phone: 508-477-5106 Email Address: goldkatc@verizon.net <br /> by the following named persons: <br /> Owner Name Owner Residence . <br /> Kitty Gold 63 Greensward Road Mashpee MA 02649 <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 /> 188-28-0696 <br /> *Signature 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 /> In case of emergency <br /> NAME: Harold Gold TELEPHONE NUMBER: 508-539-2312 <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 he subject to license suspension or revocation. This <br /> request is made under the authority of Massachusetts General Law,Chapter 62C,Section 49A. <br /> The Commonwealth of Massachusetts I3AKNS"TABLE ss k DATE <br /> Personally appeared before me the above-named `\ t 7— \ C- and made oath that the for/ statement <br /> is true. <br /> A certificate issued in accordance with this section shall be in fo cc and effect for four years front 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 /> • SEAL I �,.. <br /> 1-1 Q7JH0' <br /> 11 <br /> •°4"UCCHELUrJR <br /> � Caiou E,r�7i6rSr. <br /> �. fAiou :nnsSACNI38ETTBComm' .on Expires <br />