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FORN 812 IIOUBS 6 WARREN INC. <br /> ( iC ty or town) <br /> 4 <br /> ANNUAL REPORT - RAFFLES & BAZAARS )5 V <br /> (C. 810, Acts of 1969) (da ) <br /> Name and address of Nonprofit Organization: i <br /> MASHPFF MEMORIAL VFW POST 5489, PO .BOX 1728, MASHPEE, MA. 02649 <br /> Expiration Date of Permit: July 7, 1989 <br /> Number of Raffles and Bazaars Held: One (1 <br /> Amount of Money Received: $ 918..00 <br /> 215.44 <br /> Expenses Connected with Raffles Conducted: $ <br /> Net Proceeds: $ 702.56 <br /> For What Purposes Were The Proceeds Used? <br /> TO PURCHASE PARADE BANNERS, FLAGS AND ACCESSORIES. <br /> i <br /> i <br /> Names & Addresses of Winners of $25. 00 or More: <br /> Jerry D. Wellman 425 Sandv;(ich' Rd. , Falmouth, Ma, 02540 <br /> Nida Marceline Pleasant Lake Ave. , Harwich. Ma. 02645 <br /> i <br /> (Attach Additional Pages as Necessary) <br /> We, the undersigned, do hereby certify that this report is true and complete, j <br /> QM <br /> own <br /> 2. d AAAA^ � K 4&1-JL <br /> I . <br /> ir <br /> (Accountant) <br /> 3. t'L-A A� <br /> Report Certified to be <br /> in Conformity With <br /> C. 810, Acts of 1969: <br /> ��� <br /> Signature of Authorized Officer <br /> or Member of Organization <br /> 4City/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 />