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i <br /> BUSINESS CERTIFICATE 13 3 <br /> TOWN OF MASHPEE <br /> Date: OG1ro be <br /> 10 Expiration Date: Oc.Fnber 3 I apt V <br /> In conformity with the provisions of Chapter 110, 45 of the Massachusetts General Laws, as amended, the <br /> undersigned hereby declare(s) that a business under the title of <br /> Business Name/DBA: Great Wall Restaurant Corporation Name: JHC Restaurant, Inc. <br /> is conducted at Business Location: 401 Nathan Ellis Highway Certificate No. 2010-108 <br /> Business Type: Restaurant <br /> New [ ] Renewal [%/] Commercial [vj Residential [ ] Email Address;—dannny u ya oo.com <br /> Business Mailing Address: 401 Nathan Ellis Highway Mashpee, MA 02649 <br /> Business Telephone: 508-477-9001 Home [ ] Cell [ ] Phone: 508-477-2078 <br /> by the following named persons: <br /> Owner Name Owner Residence <br /> n <br /> �a Hua Chen 21 Quashnet Woods Drive Mashpee, MA 02649 <br /> I certify under the penalties of perjury that I, to the best of my knowledge and belief, have riled all state tax returns and paid <br /> all state taxes as required under law. <br /> *Signaturd of authorized agent "Social Security Number <br /> *This license will not be issued unless this certification is signed by applicant or Federal Identification <br /> Number(Required) <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 Chapter 62C,4 49A Massachusetts General Laws <br /> The Commonwealth of Massachusetts � <br /> BARNSTABLE: ss DATE OCEnbe: 20c), 0l.Lf <br /> Personally appeared before me the above-named -� Cgn C1, e-n 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 /> renewed each four years thereafter so long as such business shall be conducted and shall lapse and be void unless so reQne d. <br /> Signed �liA1,1 OHIK` Notary Public t t 1 �K.7� Q -g <br /> Notary Public Commission Expires <br /> grargaret C.Santos <br /> mweatlh of Massadwsetts <br /> MY scion Expires on Sept 2z 2017 <br />