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THE COMMONWEALTH OF MASSACHUSETTS <br /> ..................................................... <br /> ty or town) <br /> APPLICATION FOR PERMIT TO CONDUCT RAFFLES AND BAZAARS <br /> (C. 810, ACTS OF 1969) <br /> Name and address of Nonprofit Organization: <br /> ------------------------------------------MA�U_ Urt coon-C-1K <br /> ............................ .................................................................................... <br /> -------------------------------­-------- <br /> Evidence of Qualification for Permit: <br /> ❑ (a) Veterans'organization chartered by the Congress of the United States or included in clause (12) <br /> of section five of chapter forty of the General Laws; or, <br /> ❑ (b) Church or religious organization; or, <br /> E] (c) Fraternal or fraternal benefit society; or, <br /> (d) Educational or charitable organization; or, <br /> ❑ (e) Civic or service club or organization; or, <br /> Y4 (f) Club or organization organized and operated exclusively for pleasure, recreation and other <br /> nonprofit purposes, no part of the net earnings of which inures to the benefit of any member or <br /> shareholder. <br /> Officers or members of organization responsible for operation of raffle or bazaar: <br /> Name Residence Address <br /> (2) ------------------------------------------------------ -4------&-------cn----E <br /> -- C t.... --------Awi- <br /> g..e.....—....A <br /> 01649 <br /> (3) N.req&.0 0------------------------------------------- --_---------------- <br /> Uses to which netFrO ...proceeds will be applied: ....................................................................................................... ------- <br /> _j CL LW , t rpin -Txr)s�n <br /> 4 <br /> . T.A <br /> 04� NA 02o�rr paAAy% %A- JCAti- S=A-nak.. <br /> _A5.....................................1i....................a . . ........................ ------ <br /> --------- ------------- <br /> ou'd- lRfcm�� <br /> ...................................... ............. ................---------- <br /> (signature of authoriz o or member of org ' ation) <br /> Application certified to be in _(D9q <br /> conformity with C. 810, Acts 7 <br /> of 1960 <br /> "- City/Town Clerk <br /> PE IT (ISSUED) (DENIED) <br /> ........ .......... ..... .......... The applicant (is) tiT-ntrt) qualified to operate raffles and <br /> (date) bazaars under the pr ons of C. 810, Acts of 1969: <br /> ..... ....... <br /> Cit Town 6ierk T RYE <br /> CUR <br /> ........................ ............. ............. <br /> -ICE---- <br /> C <br /> FORM 810 HOBBS & WARREN, INC. <br />