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BUSINESS CERTIFICATE -2-01-1 633 <br /> TOWN OF MASHPEE <br /> Date: <br /> I <br /> Expiration Date: 3 / <br /> In conformity with the provisions of Chapter one hundred and ten, Section five of the General Laws, as <br /> amended, the undersigned hereby declare(s) that a business under the title of <br /> Corporation Name: Gargiulo/ Rudnick, LLP Business Name/DBA: <br /> Is conducted at Business Location: 766 Falmouth Road, RA6 <br /> Business Type: Attorneys <br /> New [ ] Renewal [Commercial [wrkesidential [ ] Email Address: &r'� let <br /> Business Mailing Address: 766 Falmouth Road,#A6 Mashpee MA 02649 ✓ <br /> Business Telephone: Home [ J Cell [ ] Phone: �;i a F (/7 7— 6 Yd <br /> by the following named persons: <br /> Owner Name Owner Residence <br /> Edward Gargiulo N/A <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 <br /> all state taxes as required under law. <br /> Fac 7 <br /> *Signature of authorized a **Social Security Number (Voluntary) <br /> *This license will not be issued unless this certification is signed by applicant or Federal Identification Number <br /> In case of emergency <br /> NAME: 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 <br /> filing or tax payment obligations. Licensees who fail to correct their non-filing or delinquency will be subject to license suspension or <br /> revocation. This request is made under the authority of Massachusetts General Law,Chapter 62C,Section 49A. <br /> The Commonwealth of Massachusetts <br /> BARNSTABLE, ss \\ DATE <br /> Personally appeared before me the above-named �GWp_A � . G,c ' �J and made oath that the foregoing <br /> statement 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 <br /> rcn c ea ou ears therea rsoien s such business shall be conducted and shall lapse and be void unless so renewed. <br /> S ned Notary Public RR .f'FQN <br /> Notoy Public <br /> Commission Expires m mmK m G"Aus buNft <br /> MyCtmAdwm604c <br /> .. hnn H,1016 <br />