Laserfiche WebLink
0 <br />(city or town) <br />ANNUAL REPORT - RAFFLES & BAZAARS _ ( Li - b F) <br />(C. 810, Acts of 1969) (date) <br />Name and address of Nonprofit Organization: <br />Expiration Date of Permit: <br />Number of Raffles and Bazaars Held: Av <br />Amount of Money Received: <br />Expenses Connected with Raffles Conducted: <br />Net Proceeds: <br />For What Purposes Were The Proceeds Used? <br />F& CCk7- Oh� b �i <br />OF <br />Names & Addresses of Winners of $25.00 or More: <br />Se e- A L 1 s-1 <br />(Attach Additional Pages as Necessary) <br />$ ya-7bro0 <br />$ 35 55, on <br />$ 7151 OD <br />We, the undersigned, do hereby certify that this report is true and complete. <br />64,)e ed,-lar <br />Eliturlt,IS ^)I blabbi <br />(Accountant) <br />Report Certified to be <br />in Conformity With <br />810, Acts of 1969- <br />City/T§wrKQLrkj <br />1. flIG <br />2. <br />0 <br />Signature of Authori ed Officer <br />or Member of Organisation <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. 12/91 tf&W Homsa WARREN T" <br />OVER <br />r7' ' 07 <br />