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BUSINESS CERTIFICATE# 0 <br /> THE COMMONIVEAL TH OF MASSACHUSETTS <br /> TOIVN OF MASHPEE '^ _ n-/O <br /> DATE pL �7 q <br /> • Expiration Date: <br /> In conformity with the provisions-of Chapter one hundred and ten, Section Eve of the General Laws, as amended, the <br /> undersigned hereby declla�r(e�(/s))�that as business underthe title <br /> � of T �^�'�(�p CAD <br /> Business Name/DBA: \ � 11AtJ�I�Jw-- C cMWIPd Ip(oorra/tiioon Name: W�\ `1 1\1<IM►L "tS'C04tlLcted at <br /> Business Location: OTM�1 W�1� �+q, <br /> Business il4ailing Address: <br /> p �►{I^�/,G,,.{ Y\e�aA fV IO�U� 1\lKret Tmeq" l /g U y� <br /> Business Type: My 1r 1^K1J����r'l�V Business Telephone: nJC�`$_ � !" 1`//�' 1� I�� <br /> Am to e. %iT "Q a'% ' A*D Email Address:KposimDm(3 K�mwipu; con <br /> by the following <br /> {named persons: /� } �{, 1 <br /> CO�m�, � er Na�� Sl 1 l�ir nen�QD.�e�• O_ Y <br /> — J TN S <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 /> top4 as required under law. �p-/n <br /> 0`4- 14 o <br /> Signature o riz a t "Social Security Number(Voluntary) <br /> or Federal Identification Number <br /> *This license will not be issued unless this certification is signed by applicant <br /> l ' In case of emergency �y� �(/� p. <br /> NAI�IE: I'Lb�1�Q1rc�^ / 'A�h- _ TELEPHONE NUM`B�E'R](�J.V(�Q 7' I�A%a <br /> Alarm Company: tJj[)t,1 {KF••� Se l'I'� ` ` r "�— �� <br /> "Your social security number will be famished to the Massachusetts Department of Revenue to determine whether ,you have met tax filing or tax <br /> payment obligations. 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 G?C, Section 49A. <br /> 1BA N 48T"f7E b c <br /> f <br /> - <br /> s /IA)OX (2400U //�� DATE Ia-gp <br /> Personally appeared before me the above-named ,f;./r , 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 ye s ther after so long as such business shall be conducted and shall lapse and be void unless so renewed. <br /> Signed �!,- • \\\Iilll//// <br /> J� .S7A7E s!� i Notary Public <br /> SEAL 2 7 <br /> TETiNESSEE L�- O _• o.O r 1 N07AF�Y Commission Expires: <br /> G► PUB► O}: <br />