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BUSINESS CERTIFICATE 6 LO <br /> TOWN OF MASHPEE <br /> • Date: <br /> Expiration Date: 71(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: 6TI \\ BusinessCinName/DBA: JT' Ir TC 1+_- <br /> is conducted at Business Location: 2 V �Ot l`f�{ JT , SOLiTI+ CF}Pf� <br /> Business Type: ��I L-U 21/s UT <br /> MA D zco�( <br /> New [�,4/Renewal [ ] -- Commercial <br /> l[ ] Rtes-idnential [ ] Email Address: k �tw,s-( IDYUhQ(G rc rJ <br /> Business Mailing Address: I I lJy �► IRS hG�L�L (NR �� , Ma� f '\ Q 2(p y q <br /> Business Telephone: Home [Q,'6ell [ ] Phone: I <br /> by the following named persons: <br /> Owner Name Owner Residence <br /> Iif LAC,, T2 (_4 <br /> I cert under the penalties of perjury that 1, to the best of my knowledge and belief, have filed all state tax returns and paid <br /> all to to as required under law. ( ' <br /> 1—& `I v -> <br /> *Signa ure f authorized agent. "Social Security Number (Voluntary) <br /> *This lice will not be issued unless this certification is signed by applicant or Federal Identification Number <br /> In case of emergency p 7�p <br /> NAME: G ([ lL-- TELEPHONE NUMBER: 5UO - 6-3 <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 I / . <br /> BARNSTABLE, ss DATE ; _w,3 <br /> Personally appeared before me the above-named 1 r A� N 0 r f 4— 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 r all be <br /> renewed each four years thereafter so long as such business shall be conducted and shall la .r <br /> Signed Notary Pu c <br /> Commission E ices <br />