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bl: W. 1305 L WARRI::: INC. <br /> KAma" Ila <br /> i..,' / <br /> Mashpee <br /> (city or town) <br /> ANNUAL REPORT - RAFFLES & BAZAARS ,74� cps: <br /> (C. 810, Acts of 1969) (date) ' <br /> Name and address of Nonprofit Organization: <br /> i <br /> Mashnee ('nmmnnitu Achnnl n1d Rarnstahle Road Mashpee MA 02649 <br /> I <br /> Expiration Date of Permit: <br /> Number of Raffles and Bazaars Held: <br /> Amount of Money Received: $ c3, 5/-7 , <br /> Expenses Connected with Raffles Conducted: $ ?3 <br /> Net Proceeds: $ <br /> 17i <br /> j <br /> For What Purposes Were The Proceeds Used? <br /> V <br /> Name"ss:/ & Addresses of Winners of $25. 00 or More:: <br /> / iliiiCiC�(' <br /> j <br /> (Attach Additional Pages as Necessary) <br /> We, the undersigned, do hereby certify that this report is true and complete. <br /> (Accountant) C <br /> 3. <br /> Report Certified to be <br /> in Conformity With <br /> C. 810, 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 />