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0 <br />7��mmt�nr� d&4. <br />%3'�a5h pe e_ <br />(ci y or town) <br />ANNUAL REPORT - RAFFLES & BAZAARS <br />(C. 810, Acts of 1969) (date) <br />Name and address of Nonprofit Organization: I <br />Cape Cod Co-mp Cor-por-CDi c0bio. FeAHe-1 OtI446or- fduCa47o. <br />(9l 5 lova-ems 13 0 MaShjme- mA Oa (A <br />Expiration Date of Permit: V e�' 01 Ua <br />Number of Raffles and Bazaars Held: <br />Amount of Money Received: <br />Expenses Connected with Raffles Conducted: <br />Net Proceeds: <br />For What Purposes Were The Proceeds Used? <br />a �;2O f b <br />$ 3750. OD <br />$ 353a. )0 <br />$ a(7. 5d <br />a4— D <br />Names & Addresses off Winners of $500.00 or More: <br />70 131 373 <br />(kUrk 2a --.e `/7,-,:D 5161''e Zvcd vvv,-� lYhO Da53a S�o,� <br />(Attach Additional Pages as Necessary) <br />We, the undersigned, do hereby certify that this report is true and complete. <br />2. <br />(Accountant) <br />Report Certified to be <br />in Conformity With <br />CActs of 1969: <br />. 10, 1 <br />M/ E <br />• City/T wit <br />ki <br />/I l� , <br />Signature of Authori d OTficer <br />or Member of Org nization <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.) <br />FORM 812 REV. H&W HoBBSB WARREN TN <br />OVER <br />