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THE COMMONWEALTH OF MASSACHUSETTS <br /> FEE <br /> .............. ......................................................... <br /> (city or town) <br /> APPLICATION FOR PERMIT TO CONDUCT RAFFLES AND BAZAARS <br /> (C. 810, ACTS OF 1969) <br /> Name a dress <br /> a dd of Nonprofit Orgjnization: <br /> e.G-E; IYI <br /> .............. . .....( <br /> ------------ ...... . ........ <br /> .................................... <br /> Evidence of Qualification for Permit: <br /> 7 (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 /> 7 (c) Fraternal or fraternal benefit society; or, <br /> (d) Educational or charitable organization; or, <br /> f-1 (e) Civic or service club or organization; or, <br /> (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 /> .......... <br /> - - ----- --- ------------5 <br /> (2) <br /> Icy l. ......u.. <br /> ------------ ------ .......C <br /> (3) t -------------------7t......(a a-a <br /> Uses to which net proceeds will be applied: . <br /> ........A.UP <br /> ....c4 <br /> ................... <br /> T-r............ . . .............................................. .................................... <br /> ........................................................................................................... ....... -------*------ ------------**......*------ <br /> ................;-Z - ................................................... <br /> Application certified to be in (sigliature of )hri. ember of organization) <br /> conformity with C. 810, Acts <br /> of.1969: <br /> City/Town Clerk <br /> J <br /> PERMIT (ISSUED) (D-F.qMD) <br /> ............... The applicant (is) (yet) qualified to operate raffles and <br /> (date) bazaars under the provisions of C. 810, Acts of 1969: <br /> .. ............. <br /> City/Town Clerk <br /> .... .......... <br /> Chief o-4oli---- ------- ---- <br /> FORM 910 HOBBS & WARREN, INC. <br />