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BUSINESS CERTIFICATE <br /> TOWN OF MASHPEE <br /> Date: Wc k r uov­y ()1 5 <br /> I <br /> Expiration Date: 19 <br /> In conformity with the provisions of Chapter 110, §5 of the Massachusetts General Laws, as amended, the <br /> undersigned hereby declare(s)that a business under the title of <br /> Business Name/DBA: Woodruff's Art Center Corporation Name: <br /> is conducted at Business Location: 1 North Market Street Certificate No. 2011-002 <br /> Business Type: Retail art supplies/art gallery <br /> New [ ] Renewal [vl Commercial [ ] Residential [ ] Email Address: amyrice29@yahoo.com <br /> Business Mailing Address: 22 Bates Road, 8151 Mashpee, MA 02649 <br /> Business Telephone: 508-477-5767 Home [ ] Cell [Phone: 508-776-6348 <br /> by the following named persons: <br /> Owner Name Owner Residence <br /> Amy Rice P,O, f'�ox 1(08?� [�J, vmj MA 02651 <br /> 401 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 taxes as required under law. <br /> 0413 0Yg 927 <br /> 'Signature of authorized agent "Social Security Number <br /> *This license will not be issued unless this certification is signed by applicant or Federal Identification <br /> Number(Required) <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 <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 Chapter 62C,§49A Massachusetts General Laws <br /> The Commonwealth of Massachusetts <br /> BARNSTABLE: ss DATE 06' 1 S <br /> Personally appeared before me the above-namedyJmA Zt,L,Q and made oath that the foregoing <br /> statement is true. <br /> I <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 <br /> 0renewed each four years thereafter so long as such business shall be conducted and shall lapse and be void unless so renewed. <br /> Signed-'-.' ���— -��---_--- Notary Public <br /> KEE] <br /> ubllo0l- aCommission Expires a' aU(7.SantosMassaayt �,2017s on Sep. <br />