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4L� BUSINESS CERTIFICATE # rU� <br /> THE COMMONWEALTH OF MASSACHUSETTS f A- <br /> TOWN OF MASHPEE <br /> . DATE � Q <br /> • Expiration Date: 3 0 <br /> In conformity with the provisions of Chapter 110, §5 of the Massachusetts General Laws,as amended,the undersigned hereby declare(s) <br /> that a business under the title of <br /> y . <br /> Business Name/DBA: eCorporation Name: <br /> is conducted at Business Location: L (�Commercial_ Residential« <br /> Business Mailing Address: <br /> Business Type: / / Q Business Telephone: <br /> New t"� Renewal [/ [ Home Phone: <br /> Email Address: l� nnLOA � C"fAl(P/I r Ike <br /> by the following named persons: <br /> Owner Name Owner Residence <br /> c5 G �P <br /> Second Owner Name Second Owner Address <br /> ify 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 /> xes as r quired under law. <br /> *Signature of authorized agent **Social Security Number or <br /> or Federal Identification Number(Required) <br /> *This license will not be issued unless this certification is signed by applicant <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 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 Chapter 62C. §49A of Massachusetts General Laws. <br /> The Commonwealth of Massachusetts <br /> BARNSTABLE ss DATE_J <br /> Personally appeared before me the above-named ZZ I t-r5r:-A1 M 'Low g and made oath that the foregoing 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 renewed each <br /> Tour years thereafter so long as such busines shall be conducted and shall lapse and be void unless so renewed. <br /> ned <br /> Notary Public <br /> SEAL <br /> Commission Expires: <br />