Laserfiche WebLink
BUSINESS CERTIFICATE iV <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> TOWN OF MASHPEE <br /> DATE Dlrpftl 21, ZOI�i <br /> • Expiration Date: n <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 /> Business Name/DBA: Jia-u-P G (�� V � Corporation Name: / <br /> is conducted at Business Location: I I AJ ���/ e Commercial_ Residential <br /> 11 <br /> Business Mailing Address: 11 1 Q <br /> Business Type: ( leC- G�GP M� 0T�`ln4 QIPS Business Telephone: <br /> New ( Renewal [ ] Home Phone: <br /> Email Address: PY1Q�Sr t"��[1rn 12tt 6)cA mai l -c m^ <br /> by the following named persons: <br /> Owner Name Owner Residence <br /> MoMkvm ScbTc, IntCr-o Iq SUjCDr�ve, MCAs�, 2 <br /> Second Owner Name Second Owner Address <br /> O;axes <br /> fy der the pe ties f perjury that I, to the best of my knowledge and belief, have filed all state tax returns and paid all state <br /> quired under <br /> aa�Qaa��� <br /> ature of a thorized "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 c DATE <br /> Personally appeared before me the above-named rna/�Acef) JW 1 m•e_r o 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 four <br /> years thereafter ong as suit t business shall be conducted and shall lapse and be void unless so renewed. <br /> 0ed <br /> t otary Public <br /> Notary Public <br /> S <br /> Margaret C.Santos <br /> Commomveoof Massachusetts Commission Expires:' <br /> y Commfssl xt Expires on Sept.22,2017 <br /> 9M) 7 <br />