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r A <br /> IMPORTANT!!!-PLEASE READ THE FOLLOWING PARAGRAPHS <br /> A. Gross proceeds derived from a raffle are the total receipts from the sale of all tickets certain among which entitle holders <br /> to prizes, as determined by chance after the sale. <br /> B. Gross proceeds derived from a bazaar are the total receipts from the sale of all tickets or other evidences of chance for <br /> the disposal (by means of chance)of awards permitted under Section 7A of Chapter 271 of the General Laws. <br /> C. Any organization conducting a raffle or bazaar MUST FILE a return and PAY a tax of FIVE PER CENT of the GROSS <br /> PROCEEDS within TEN DAYS after each raffle or bazaar. See Section 7A of General Laws Chapter 271 as inserted by <br /> Chapter 810 of the Acts of 1968 and amended by Chapter 219 of the Acts of 1977. <br /> D. INTEREST AND PENALTY <br /> 1. Interest — Charged at 12% from date due to the date paid. <br /> 2. Penal yfor Late Firing of Return—One percentof thetaxdueforeach month or part thereof from date return due to the I, <br /> date filed up to a maximum of 25%the tax due. <br /> 3. Penalty for Late Payment of Tax—One-half of one percent of the tax due for each month or part thereof from the date <br /> tax due to the date paid up to a maximum of 25% of the tax due. <br /> E. Adequate books and records must be maintained and kept to substantiate compliance with the five per cent gross proceeds <br /> tax. For tax auditing purposes, such books and records should be preserved and available for a period of three years after <br /> each return is filed. <br /> I DECLARE UNDER THE PENALTIES OF PERJURY THAT THIS RETURN HAS BEEN EXAMINED BY ME AND TO THE BEST <br /> OFW-KNOWLEDGEO BELIEF IS A TRUE, CORRECT AND COMPLETE RETURN. <br /> - I <br /> SIGNATU E OF AUTHORIZED OFFICIAL TITLE 3 DATE i <br /> AREA BUSINESS TEL NO. <br /> i <br /> RESIDENCE ADDRESSt�- <br /> 6 AREA HOMEPHONE <br /> CITYOR T <br /> COMMENTS AND/OR COMPUTATION OF PENALTIES AND INTEREST <br /> f <br /> i <br /> 1 <br /> i <br />