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BUSINESS CERTIFICATE# <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> TOWN OF MASHPEE <br /> DATE 1 5 <br /> . Expiration Date: <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: Ce }er o•f Ce,. (e Corporation Name: F, 1µt&33 ALL C <br /> is conducted at Business Location: y J UV S}. Commercials Residential_ <br /> Business Mailing Address: <br /> Business Type: R e-�c ( IAl.l +r,•4•�ot^ 3+L)C e— Business Telephone: <br /> New Renewal ] ] Home Phone: . <br /> Email Address: 1`n P. ]i 5 Sea C.y NJ Cor" <br /> by the following named persons: <br /> Owner Name Owner Residence <br /> In e, It, SS e S-lzhn < wa-, f. Scna(w,'cA rn p <br /> i <br /> Second Owner Name Second Owner Address <br /> Otify 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 /> taxes as reyfired under law. <br /> *Signa a 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 0-0-i <br /> Personally appeared before me the above-named e_I S Sa to P�' and made oath that the foregoing statement is true. <br /> A certificate issued in accordance with this section shall be in force and effect Por four years from the date of issue and shall be renewed each <br /> four years thereafter so long as such business shall/be conducted and shall lapse and be void unless so renewed. <br /> 1� <br /> �ed <br /> Notary_ Publ c <br /> SEAL Deborah Dami <br /> o� NOTARY PUBLIC Commission Expires: <br /> Commonwealth of Massachusetts <br /> My Commission Expires July 29,2016 <br />