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BUSINESS CERTIFICATE# a)/3 <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> TOWN OF MASHPEE <br /> DATE S �' <br /> . Expiration Date: 3 <br /> In conformity with the provisions of Chapter one hundred and ten, Section five of the General Laws, as amended, the undersigned hereby <br /> declare(s) that a business under the title of <br /> Business Name/DBA: Dunkin Doughnuts Corporation Name: New Generation Donuts,LLC is conducted <br /> at <br /> Business Location: 401 Main Street <br /> Business Mailing Address: PO Box 1149,Brockton,MA 02303 <br /> Business Type: Coffee Shop Business Telephone: 508-680-6695 <br /> New I I Renewal J Certificate# 2009-016 Expiration Date 2/28/2013 <br /> Home Phone: Email Address: <br /> by the following named persons: <br /> III `c Owner Name Owner Residence <br /> 'rc' <br /> John Cadete , <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 taxes as <br /> reb under law. <br /> *Signature of authorized agent "Social Security Number(Voluntary) <br /> or Federal Identification Number <br /> Bush *This license will not be issued unless this certification is signed by applicant <br /> Nc In case of emergency <br /> NAME: TELEPHONE NUMBER: <br /> liotnc( . <br /> Alarm Company: <br /> by the Iii' <br /> *•Your social security number will be furnished to the Massachusetts Department of Revenue to determine whether you have met tax filing or tax payment <br /> gbligittions. Licensees who fail to correct their non-filing or delinquency will be subject to license suspension or revocation. This request is made under <br /> the authority of Massachusetts General Law,Chapter 62C,Section 49A. <br /> The Commonwealth of Massachusetts <br /> BARNSTABLE ss 1 DATE 3I 2� l3 <br /> ac: <br /> appeared before me the above-named ��'if i G10 RUtal"1 A J'e S and made oath that the foregoing statement is true. <br /> a is ued in accordance w' sec ' n shall be in force and effect for four years from the date of issue and shall be renewed each four <br /> years therng such busi s shal be c due d and shall lapse and be void unless so renewed. <br /> Signed Q <br /> Signed <br /> Notary Public Nota Public <br /> Margaret C. Santos <br /> Commonwealth of Massachusetls 9/ ` m is aG t1 <br /> ty Commission Expires on Sept.22,2017 Commission Expires: <br /> A:o CC J ' <br /> •p(tfF <br />