The Commonwealth of Massachusetts

IN CONFORMITY WITH THE PROVISIONS OF CHAPTER ONE HUNDRED AND TEN, 
SECTION FIVE OF THE GENERAL LAWS, AS AMENDED THE UNDERSIGNED HEREBY
DECLARE(s) THAT A BUSINESS IS CONDUCTED UNDER THE TITLE OF:


_________________________________________________________________

IS CONDUCTED AT _________________________________________________

                _________________________________________________

BY THE FOLLOWING NAMED PERSON(s):  (INCLUDES CORPORATE NAME AND
TITLE, CORPORATE OFFICER)

     FULL NAME                               RESIDENCE

_________________________           _____________________________

_________________________           _____________________________

_________________________           _____________________________

_________________________           _____________________________

SIGNATURE:

_________________________           _____________________________

_________________________           _____________________________

DATE: ___________________           ____________________________SS.

      PERSONALLY APPEARED BEFORE ME THE ABOVE NAMED _____________

_________________________________________________________________

AND MADE OATH THE FOREGOING STATEMENT IS TRUE.

                              ___________________________________
                                        Title


IN ACCORDANCE WITH THE PROVISION OF CHAPTER 337 OF THE ACTS OF 1985 
AND CHAPTER 110, SECTION 5 OF MASS. GENERAL LAWS, BUSINESS
CERTIFICATES SHALL BE IN EFFECT FOR FOUR YEARS FROM THE DATE OF
ISSUE AND SHALL BE RENEWED EACH YEAR FOUR YEARS THEREAFTER.  A
STATEMENT UNDER OATH MUST BE FILED WITH THE CITY CLERK UPON
DISCONTINUING, RETIRING, WITHDRAWING OR CHANGE OF LOCATION OF
BUSINESS OR RESIDENCE FROM SUCH BUSINESS OR PARTNERSHIP.


                         CERTIFICATE EXPIRES: ____________________


* This form is not valid until it has been filed and registered by
the City Clerk's Office, and bears a certification stamp and seal.