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or town) <br />. ANNUAL REPORT- RAFFLES & BAZAARS (D&6 � Y� <br />(C. 810, Acts of 1969) (date) <br />Name and address of Nonprofit Organization: <br />as <br />Expiration Date of Permit:__. 20 <br />• <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 />n_ _ n . r O <br />Names & Addresses �j Winners of $25. 00 or More: <br /><i_"//(,,%1a A( -t . 9_9 "") <br />(Attach Additional Pages as Necessary) <br />$ SOd <br />$ :5q <br />$ <br />We, the undersigned, do hereby certify that this report is true and complete. <br />2 <br />(Accountant) <br />3 <br />Report Certified to be <br />in Conformity With <br />C. 810, Acts of 1969: <br />City/Town Clerk <br />44X S4 d <br />Signature of Authorized Officer <br />or Member of Organization <br />RENEWAL PERMIT WILL NOT BE ISSUED TO LICENSEE UNTIL THLS REPORT <br />