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• Ma5hp <br />(city or town) <br />ANNUAL REPORT - RAFFLES & BAZAARS 7 45'08 <br />(C. 810, Acts of 1969) (date) <br />• <br />Name and address of Nonprofit Organization: <br />� � vrd� ►P, �- illa�.hpu- U <br />Expiration Date of Permit: <br />Number of Raffles and Bazaars Held: 2 <br />Amount of Money Received: $ <br />Expenses Connected with Raffles Conducted: $ <br />Net Proceeds: $ <br />For What Purposes Were The Proceeds Used? <br />SaD1)a�# ti. "� ?1 <br />f A—ms <br />Names `& Addresses of Winners of $500.00 or More: <br />NIA <br />(Attach Additional Pages as Necessary) <br />$ I.08• <br />1,500. <br />700 . <br />Goo . <br />We, the undersigned, do hereby certify that this report is true and complete. <br />1 <br />2. <br />(Accountant) <br />3. <br />Report Certified to be <br />in Conformity With <br />C. 8 0, Acts of 1 69 <br />City/T n er <br />ue of Authorized Officer <br />or Member of Organization <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 HOBBS& WARREN <br />OVER <br />