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FORM 812 110065 6 WARREN INC. <br /> _ Y I <br /> Mashpee, MA <br /> (city or town) <br /> ANNUAL REPORT - RAFFLES & BAZAARS November 25, 1986 <br /> (C. 810, Acts of 1969) (date) <br /> Name and address of Nonprofit Organization: <br /> Carney Hospital <br /> ' Expiration Date of Permit: March 24, 1987 <br /> i <br /> Number of Raffles and Bazaars Held: One <br /> Amount of Money Received: $ 325,443 <br /> Expenses Connected with Raffles Conducted: $ 161,687 <br /> Net Proceeds: $ 163,756 <br /> For What Purposes Were The Proceeds Used? <br /> Purchase of Capital Equipment for the Carney Hospital. <br /> Names & Addresses of Winners of $25,00 or More: <br /> Michael J. Farrell <br /> 25 Sherwood Road <br /> Weymouth, MA 02191 i <br /> (Attach Additional Pages as Necessary) <br /> We, the undersigned, do hereby certify that this report is true and complete. <br /> 1, John W. Logue <br /> r <br /> �-� 2, +�, ,, �/ »71��emas J. Devane <br /> 7-1 <br /> cc ntant) a�� <br /> 3•(IC t�t �.sC Paul A. Vielkind <br /> Report Certified to be <br /> in Conformity With <br /> C. 810, Acts of 1969• > <br /> • John W. Logue, President <br /> 6,11 Si :ure of Authorized Officer <br /> o ember 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 />