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TOWN OF MASHPEE BUSINESS CERTIFICATE <br /> ' <br /> Date: <br /> • Expiration Date: <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 /> Business Name/DBA: Nichols Investment Advisory Services Corporation Name: <br /> is conducted at Business Location: Z s Steeple Street <br /> Business Type: Investment Services <br /> New [ ] Renewal [ ✓r Commercial [ ] Residential [ ] Email Address: <br /> Business Mailing Address: PO Box 1587 Mashpee, MA 02649 <br /> Business Telephone: 508-539-1155 Home [ ] Cell [ ] Phone: 508-539-1155 <br /> by the following named persons: <br /> Owner Name Owner Residence <br /> Christopher Nichols <br /> •I certify un ert penallies e ' ry that I to the best of my knowledge and belief, have filed all state tax returns and paid <br /> all state as ired <br /> equun <br /> *Si re of authorized agent **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 oferrlergency G� [� <br /> NAME: C "� �G /6O'"G' %� Z-4 TELEPHONE NUMBER: �d Ste! �Z�c e <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 /> Tire Commonwealth of Massachusetts c/ <br /> BARNSTABLE, ss DATE D <br /> Personally appeared before me the above-named and made oath that the foregoing <br /> statement is true. <br /> A c h • is •c s n shall be in force and effect for four y mT'T to of issue and shall be <br /> renewed enc there or 8�su usin II be conducted and shall lapse and a void unless so enewed. <br /> itMASS ! <br /> Signed t& ,ormissi FJ Ir Notary Public <br /> • 2! 101 <br /> Commission Expires <br />