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THE COMMONWEALTH OF MASSACHUSETTS <br /> FEE <br /> / $10.00 <br /> ........................ <br /> Y <br /> (city 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 /> ... ,ice.• <br /> _- �r , l % _�J a� ------------ <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 /> ❑ (c) Fraternal or fraternal benefit society; or, <br /> (d) Educational or charitable organization; or, <br /> ❑ (e) Civic or service club or organization; or, <br /> ❑ (f) Club or organization organized and operated exclusively for pleasure, recreation and other j <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: i <br /> Name Residence Address <br /> i <br /> 'fes = _.�__ / meg✓ <br /> �3) - ---------- <br /> Uses <br /> --- -Uses to which net proceeds will be applied: -- <br /> (fLtiLa �2C �yKQl4.eQ--•� . <br /> GAO-'1•--_ <br /> ' -amu----u---�� - - - •-�2��:� _.. <br /> --------------------- <br /> -------- ...X-4 <br /> (signature of authorized offieer or member o organization) <br /> Application certified to be in <br /> conformity with C. 810, Acts <br /> of 1969: j <br /> 49ityTTown Clerk <br /> I <br /> „I <br /> '1 <br /> PERMIT (ISSUED) B� <br /> L , <br /> ......... The applicant (is) O qualified to operate raffles and <br /> (date) bazaars under the provisions of C. 810, Acts of 1969: <br /> -- c <br /> City/Town Clerk <br /> ChiefPolice <br /> j <br /> FORM 810 HOBBS & WARREN, INC, <br />