Laserfiche WebLink
THE COMMONWEALTH OF MASSACHUSETTS <br /> FEE <br /> .....-.Lowz..o4.lrlooh. -- <br /> e--- -•------- ------•----........---..........._.................. <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 /> ..........................•---•------...------............................. <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 /> U (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 /> i <br /> Name Residence Address <br /> (1) L. Pact DAa4e. P"-4. Toon " rive. iia 6ee 14a. 02649 P.O. Box 391 <br /> ------•.....-----•--•----•----•- ----------- - ----•---.....-----•.... °` ...........;.....--1--...--------------------------...----------------------------•-------. <br /> o <br /> (2) .. �gG�t.i I�? <br /> Aii.GCi arrc.�(7...;n.,l.!_o,..Secr .: ?d. aaAvee,-Cla...D2649 �.D..BOX--I&..... <br /> fxanh . H.i cA6 Tneao. main S4. ?a,61w Aa. 0, 649 P.O. 13ox214 <br /> Uses,to which net proceeds will be applied: .,je.2eoeawA..and.-neLat.k.� a v�f^_-_-____•_____-_••_-__ <br /> -----------------------------------------------------------•---------.._...------------•--•-•----••----------•------••----------------.........------------•-•----•-•-------- <br /> (signature of authorized officer or member of organization) <br /> Application certified to be in <br /> conformity with C. 810, Acts <br /> of 1969: <br /> City/Town Clerk <br /> PERMIT (ISSUED) (DENIED) " + <br /> J! ,1-a te/.................... ....... The applicant is qualified tooperate raffles and <br /> (dates - PP (• ) (�• q <br /> bazaars under the provisions of C. 810, Acts of 1969: <br /> City/Town Clerk <br /> .......... ---- --- - ---------- <br /> r Chief o H <br /> FORM 810 HOBOS a WARREN, (NC. <br />