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ti <br /> k <br /> License will not be issued unless this ce rti ficationclause Is signed, <br /> I certify; under the penalties of perjur that to the best o <br /> Y f my knowledge and belief,, I have filed all state <br /> tax returns and paid all state and local taxes as y <br /> req uired b 'law <br /> Signature of Individual <br /> or Corporate Name (Ma <br /> ndatory). �� t� �� �� VVV <br /> � Gate. <br /> By Corporate officer. . <br /> . SSN/FEIN. 47-5239197 <br /> ,(Mandatory if.ap licable <br /> . p ) <br /> k . <br /> *'dour Social Security Number or Federal Identification •Number will be furnished to the Massachusetts <br /> Department of Revenue (DOR) to determine whether you have met tax i <br /> Y filing or tax payment obl�gations, <br /> Licensees failing to correct their non-filln or d6lin uenc, i <br /> g q y will be subaect to license suspension or <br /> revocation, This request is made under the authorityof M,G.�. c,'62C §49A.', <br /> k <br /> Rage 1 <br /> k <br />