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FOFB 812 HOBBS S WARREN INC. <br /> i <br /> ( t *t n <br /> y <br /> ANNUAL REPORT - RAFFLES & BAZAARS <br /> (C. 810, Acts of 1969) (d te) <br /> Name an ddr ss of Non ofit Organizatio ; <br /> Expiration Date of Permit: <br /> Number of Raffles and Bazaars Held: <br /> JJJ S' <br /> Amount of Money Received: $ e� CJ <br /> Expenses Connected with Raffles Conducted: <br /> Net Proceeds: $ �/ ♦ �� <br /> For What Purposes Were The Proceeds Used? <br /> Names & Addresses of Winners of $25, 00 or More: <br /> (Attach Additional Pages as Necessary) <br /> We, the undersigned, do hereby certify that is report is true nd mplete, <br /> 1. <br /> (Accountant) �a <br /> i I <br /> 3. <br /> Report Certified to be <br /> lex <br /> in Conformity With <br /> C, 8109 Acts of 1969: ` <br /> Signature of Authorized ,Officer <br /> or Member of Organization <br /> City/Town Clerk <br /> RENEWAL PERMIT WILL NOT BE ISSUED TO LICENSEE UNTIL THIS REPORT <br /> HAS BEEN COMPLETED AND FILED WITH THE COMMISSIONER OF PUBLIC SAFETY. <br /> (Permit Holders also holding Beano Licenses,must submit a Copy of this Report to the Massachusetts State Lottery Commission.) Revised January 1974 <br />