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BUSINESS CERTIFICATE # <br /> THE COMMONI9/EALTH OF MASSACHUSETTS <br /> TON/N OF MASHPEE <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 decla�re(s�) that a business under the(title of <br /> Business NameNBA: 1// l'tp� NJQ _ f- poration(�Name: is <br /> conducted at <br /> Business Location: �P O I 4L�(�` t^-�^ <br /> Business Mailin/gn(Address:0y S' k"K-P <br /> Business"I',ype: '' 4o-A �T-°�'L Business Telephone: <br /> ]ionic Phone: 379 6''-1�"�-� 3� Email Address: C➢ of P L)-gy'LZ011 ✓L�I— <br /> by the following named persons: O <br /> ,{,, f {� / ,( <br /> ® � O_ Ivner N:'yIe I V d�� GI �1 wnResidence <br /> (Y /VI <br /> Q ( ' <br /> I certify under the penalties of perjury that 1, to the best of my knowledge and belief, have filed all state tax returns and paid all state <br /> Iax s required under. law... . <br /> *Signature of author' ed 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 <br /> NAME: TELEPHONE NUMBER: . <br /> Alarm Company: <br /> **four social sectu ity number will be furnished to the Massachusetts Department of Revenue to dcterminc 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 susnension or revocation. This request <br /> is made under the authority of Massachusetts General Law,Chapter 62C, Section 49A. <br /> The Commonwealth of Massachusetts <br /> BARNSTABLE ss DATE 3 - 1- 8011 <br /> Personally appeared before me the above-named _001c okL'4 `� 'A k and made oath that the foregoing statement is <br /> true. d <br /> A certificate issued in accordance with this section shall be in force and effect for four years Gom 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 /> �. -w •- -7 Notary Public <br /> SEAL <br /> • Notary Public G} 2 - a E I re <br /> - Me/geret C.Santos Commission Expires: <br /> CmwonweW of Massachusetts <br /> My Commission Expims an Sept.22,2017 <br />