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BUSINESS CERTIFICATE_C <br /> • TOWN OF MASHIPEE <br /> Date: <br /> Expiration Date: - Y 1(Cee.1 3 t opal 1l <br /> In conformity with the provisions of Chapter one hundred and ten, Section five of the General Laws, as <br /> amended, the undersigned hereby declare(s) that a business under the title of <br /> Business Name/DBA: Cape Kaleidoscopes Corporation Name: <br /> S <br /> is conducted at Business Location: 34a+� Certificate No. 2010-058 <br /> Business Type: retail <br /> New [ ] Renewal [1, Commercial [ ] Residential [ ] Email Address: capekaleidoscopes@hotmail.com <br /> Business Mailing Address: PO Box 518 Mashpee, MA 02649 <br /> Business Telephone: 508-477-0661 Fell [%4 Phone: 4 <br /> by the following named persons: <br /> Owner Name Owner Residence <br /> •uzanne Greene e a <br /> ilg Maakpa , oa( 6_�69�p <br /> 1 certify under the penalties of perjury that I, to the best of my knowledge and belief, have filed all state tax returns and paid <br /> all state ta•; s as required undeV <br /> -,-Y- Ya yK <br /> * n cure of authorized agent **Social Security Number(Voluntary) <br /> g ) <br /> *This license will not be issued unless this certification is signed by applicant or Federal Identification Number <br /> In case of emergency <br /> NAME: _� Cir L 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 Massachusetts General Law,Chapter 62C,Section 49A. <br /> The Commonwealth of Massachusetts <br /> BARNSTABLE, ss DATE <br /> Personally appeared before me the above-named _"nt AC,CZ"Z- and made oath that the foregoing <br /> statement is true. V <br /> A certificate issued in accordance with this section shall be in farce and effect for four years from 11`�``��QA• 1 (j��`'��S��I be <br /> �newed each four years ther after so long as such business shall be conducted and shall lapse and be void u^�SeTtct'�e"7(y•, <br /> Signe /�t/ Notary Public <br /> C t �• <br /> Commission Expires <br />