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BUSINESS CERTIFICATE# 2A)0Z_6 Z 1 <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> TOWN OF MASHPEE -Z C:) <br /> DATE <br /> Expiration Date: �' Y// <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: %FDJ r.b WaOAF: Corporation Name:CoMrASr RQOADPAMb W A= is conducted at <br /> Business Location: �6J( FRIG W 4P13-I6tNAS PEF1 "A 0?J-&N9 <br /> Business Mailing Address: p_r ro rc hW a Gk nwk, mQl .tM IN UDr Pt4i ADELF"XA, PA IgM3 <br /> Business Type:Jb)Mt_L_%SFR trr 2 Dna tTrat Business Telephone: J IS—7 RL, — 4 VIA <br /> seclui TY 9V3T5M5 <br /> Home Phone: Email Address: <br /> by the following named persons: <br /> Owner Name Owner Residence., 1�yN4/6tuexrD��� <br /> "\OHA.� J. Ion Lk 14 `Kry X35 F. Istoti <br /> Gejd9b <br /> I certi b u er a 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 r q i rider law. <br /> L,7- 2236,5LIB <br /> i e 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: Add TELEPHONE NUMBER: A//A <br /> Alarm Company: A).48 <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 subiect 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 3 <br /> BARNSTABLE ss I DATE 3 r) <br /> Personally appeared before me the above-named A d u VMM \ �I,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 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 NOTARIAL SEAL 25-- ,& <br /> • _ _ VERONICA L Commission Expires: <br /> ' Notary Public' <br /> PHILADELPHIA CITY,PHILADELPHIA COUNTY <br /> My Commission Expires Mar 31,2015 <br />