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" ~ BUSINESS CERTIFICATE# "YO <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> TOWN OF MASHPEE <br /> DATE <br /> • 1 l /U gk-1, 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 underthe title of p <br /> Business Nante/DBA: ^0x*A Spasm/ Ujola 4dfa Corp � <br /> Corporation ,Lt�f��(SItAD \C/YHY11dYN�[t� <br /> is conducted at Business Location: &q 66- 2u C2 u) Commercial—Residential ✓ <br /> Business Mailing Address: SOAwke /y <br /> Business Type: (!C JSOL-n J4G OAALy Business Telephone: Sot 29a <br /> 'AY7 y <br /> Business Phone,93* A92-5936 Home Phone: Email Address: <br /> CVM <br /> by the following named persons: CLI e C iP b fes' <br /> 1 OwndLnie ^� 0 er Res' ence <br /> V1tnr�oc "LLAAn " HfSILp laq A GQ ?ayce ftJW l <br /> 7:S&W 0J renals Is�n <br /> I certify under the penalties of perjury that I, to the best of my knowledge and belief, have filed all state tax returns and paid all state <br /> ta. required under law. <br /> s 3o - o ro&E-S9 <br /> n.etre 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 /> n In case of emergency n <br /> NAME—4sNor-9 TELEPHONE NUMBER: <br /> Alarm Company: <br /> i <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 Commonwealth ofHassachusells <br /> BARNSTABLE ss DATE <br /> It a <br /> Personally appeared before me the above-name l ) rJ� 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 from the date of issue and shall be renewed <br /> --eas our years therealler so long as such business shall be conducted and shall lapse and be void unless so renewed. <br /> Signed LZ <br /> • Notary Public . <br /> SEAL <br /> ommiss'o iiEl?{lPbENe F- <br /> COYYl1N1YFlIL1M OF <br /> 1�t,07NNN11NI0D E7dfM <br />