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BUSINESS CERTIFICATE <br /> �- <br /> TOWN OF MASHPEE <br /> Date: 1 / <br /> Expiration Date: <br /> In conformity with the provisions of Chapter 110, §5 of the Massachusetts General Laws, as amended, the <br /> undersigned hereby declare(s) that a business under the title of <br /> Business Name/DBA: Professional Business Systems -Corporation Name: <br /> is conducted at Business Location: 35 Santuit Pond4e&,q2A Certificate No. 2010-024 <br /> Business Type: Accounting <br /> New [] Renewal commercial ] ] Residential [ ] Email Address: <br /> Business Mailing Address: PO Box 270 Forestdale, MA 02644 <br /> Business Telephone: 508-477-6279 Home [ ] Cell [ ] Phone: 508-477-6279 <br /> by the following named persons: <br /> Owner Name Owner rRR�esidence <br /> Thomas Larner 35 Santuit Pond =42A Mashpee, MA 02649 <br /> 1 certify under he penalties of �rjury that I, to the best of my knowledge and belief, have filed all state tax returns and paid <br /> A&all state t s as re x e un (law. p y <br /> Signature o thorized agent <br /> *This license I 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,§49A Massachusetts General Laws <br /> The Commonwealth of Massachusetts <br /> BARNSTABLE: ss DATE %of- 3- ;?o / V <br /> Personally appeared before me the above-named (1r1orYta-s (12(A-e✓— and made oath that the foregoing <br /> statement is true. <br /> A certificate i ue actor nce with this section shall be in force and effect for four years from the date of issue and shall be <br /> renewed each to <br /> s th a er ong as su business shall be conducted and shall lapse and be void unless so renew <br /> Signed Notary Public n <br /> u Commission Expires 0t. - <br /> Notary Public <br /> SkMargaret C.Santos <br /> Commonwealth GI Massachusetts <br /> y Commission Expim-on Sept.22,2017 <br />