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THE COMMONWEALTH OF MASSACHUSETTS <br /> FEE <br /> $10.00 <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 /> ............M.4-4..k VC. - <br /> ............................ <br /> ............................................................................................................................................................................ <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 <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 <br /> Residence Address <br /> (1) �—,�Jeu-/.......... --------------- - -------- ....... ..... . . .....M <br /> (2) ... <br /> ------------------------------- - - ----------- <br /> ...... ............................. <br /> (3) .................................. .........................-Deer . <br /> ................... <br /> [;.ses to which net proceeds will be applied: <br /> ............................. .............................. <br /> ��tk&........................... .............. ..... ................ <br /> ........................................................ ............................................................ ........................................................... <br /> ---------------- <br /> 0i a ureof ,r or organization) <br /> Application certified to be in ,mb,,Oi <br /> conformity with C. 810, Acts <br /> of 1969 <br /> .... ..... ....................... <br /> City/Town Clerk <br /> PERMIT (ISSUED) (DraNURD) <br /> ............................. ...... .......... <br /> The applicant (is) (40=ftatj qualified to operate raffles and <br /> (date) bazaars under the provisions of C. 810, Acts of 1969: <br /> ---------- <br /> ---------- <br /> City/Town Clerk <br /> -.-ef. .. .......... <br /> Chie"i Po <br />