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BUSINESS CERTIFICATE# 26 !0^ /3 <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> TOWN OF MASHPEE 6 <br /> DATE <br /> • Expiration Date: <br /> In conformity with the provisions of Chapter one hundred and ten, Section five of the General Laws, as amended, the <br /> undersigned hereby declare(s) that a��business under the title <br /> �of ��� ����Q .�J <br /> Business Name/DBA: WG(Cv- 'n C Corpo�tion Name: S�[/^^� 'f � - is�duc[ed at <br /> Business Location: C7�7' ' <br /> BusinessiWailingAaaddre�ress: ��h �/ 2 wrL 19/ <br /> Business Type: Business Telephone: ?-Oa.3/B' $76 J <br /> Home Phone: 5N' I-f 1-580 (p Email Address: <br /> by the following named persons: <br /> Owner Name' L Owner Residence z <br /> Si'/ V �L S I�QT V IoGi�a f L C! rpt. - , <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 <br /> taxes as req ed under law. <br /> as req <br /> al <br /> ru/e o authorized agent *"Social Security Number(Voluntary) <br /> or Federal Identification Number <br /> *This license will not be issued unless this certification is signed by applicant <br /> In case of emergency n/ <br /> NAME: TELEPHONE NUiMBER:�,QQ� ,3 I2, ,��? <br /> Alarm Company: Otbuo <br /> "Your social security number will be furnished to the Massachusetts Department of Revenue to determine whether you have met tax filing or tax <br /> payment obt igai ions. Licensees who fail to correct their non-filing or delinquency will be subject to license suspension or revocation. This request <br /> is made under the authority of Massachusetts General Law,Chapter 62C,Section 49A. <br /> The Commonwealth of Massachusetts <br /> BAMNSTABLE ss DATE <br /> Personally appeared before me the above-named and made oath that the foregoing statement is <br /> 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 renewed <br /> each four years thereafter so long as such business shall be conducted and shall lapse and be void unless so renewed. <br /> Signed <br /> Notary Public <br /> SEAL <br /> Commission Expires: <br />