Laserfiche WebLink
✓.� J'\�O.tS <br /> TOWN OF MASHPEE <br /> I'LL <br /> `O� Statement of Discontinuance, Change of Residence,Change of Location of Business, <br /> Withdrawal,or Deceased from Business or Partnership,Change of Business Name or Owner Name <br /> --A taousf \4, 3015— <br /> DATE <br /> 430f5 <br /> The Town is desirous of going"Green" as much as possible.To that end, please include your email address. <br /> Email Address: <br /> Discontinuance <br /> In conformity with the provisions of Chapter one hundred and ten, section five, of the General <br /> Laws, as amended, the undersigned hereby declare(s) that 1/We has (have) this day discontinued (retired <br /> from) (withdrawn from)the business of <br /> conducted at <br /> STREET <br /> SIGNATURE <br /> Change of Location of Business <br /> I hereby state that the location of the business/my residence as it appears on the Business Certificate filed <br /> on has been changed to <br /> Name of Business <br /> I <br /> SIGNATURE <br /> i <br /> . Change of Name of Business or Owner <br /> I hereby state that the name of the business or the owner as it appears on the Business Certificate has <br /> been changed from ��t°�lrs � Ql��esF7 �la�fvteKLe <br /> to . )C-)V\ j,`5� �IUN+bi l�j qK r1 Nes+i tcj <br /> SI RE <br /> Notary <br /> Barnstable ss. <br /> Date <br /> Personally appeared before me the above named and made oath <br /> that the foregoing statements are true. M <br /> tl Notary PUb1iC ame-Notary Publi <br /> Margaret C.Santos �} • <br /> COmmoflwealfh Of MasSaChu58iIS Commission Expires <br /> My Commission Ex fires on Sept.22,2017 <br /> Origform/Discontinuance <br />