FOR THE QUARTER ENDING SEPTEMBER 30, 2009 AND THE PERIODS THEREAFTER

          STS-Q             MASSACHUSETTS DEPARTMENT OF REVENUE                                                  1.GROSS SALES OF
                     QUARTERLY SALES/USE TAX ON SERVICES RETURN                                                    SERVICES
              Q             YOU SHOULD FILE THIS FORM EVEN THOUGH NO TAX MAY BE DUE                              2.SALES FOR RESALE/
              FEDERAL ID NO.DOR USE ONLY                   FOR QTR ENDING                                          EXEMPT SALES OR
                                                                                                                   OTHER ADJUSTMENTS
                                                                                                                 3.TAXABLE SALES 
              IF NOT CORRECT, CHANGE HERE AND ON REVERSE                            DO NOT ALTER                   (LINE 1 MINUS LINE 2;
BUSINESS NAME                                                                                                      NOT LESS THAN ZERO)
IF NOT
CORRECT                                                                                                          4.USE TAX PURCHASES
BUSINESSPLEASEADDRESS
PRINT
CHANGES                                                                                                          5.TOTAL TAXABLE AMOUNT
CITY/TOWNHERE               STATE                       ZIP                                                        (ADD LINE 3 AND LINE 4)
_________❿
                                                                                                                 6.TOTAL TAXES
                                                                                                                   (LINE 5 ×.0625)

                                                                                                                 7.PENALTY
Return is due with payment on or before the 20th day of the month following the month indicated above. Make check
or money order payable to Commonwealth of Massachusetts You should file this form even though no tax may
be due. Mail to: Massachusetts Department of Revenue, PO Box 7015, Boston, MA 02204.
I declare under the penalties of perjury that this return (including any accompanying schedules and statements)  8.INTEREST
has been examined by me and to the best of my knowledge and belief is a true, correct and complete return.
SIGNATURE                   TITLE                          DATE                                                  9.TOTAL AMOUNT DUE
                                                                                                                   (ADD LINES 6, 7 AND 8)

IF THIS IS A FINAL RETURN, INDICATE REASON:
BUSINESS DISCONTINUEDCHANGE IN ORGANIZATIONBUSINESS TRANSFERRED       BUSINESS SOLD
OTHER                                                                 LAST DATE OF BUSINESS

IF BUSINESS WAS SOLD OR ITS OWNERSHIP CHANGED, COMPLETE THE FOLLOWING:
NAME OF NEW OWNER
ADDRESS OF NEW OWNER
DATE OF TRANSFER

IF ANY OF THE FOLLOWING HAS CHANGED, ENTER NEW INFORMATION:
NAME OF BUSINESS
ADDRESS OF BUSINESS
FEDERAL IDENTIFICATION NUMBER                                         DATE OF CHANGE

6M 2/02 CRP0198                                                                            printed on recycled paper