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  Sponsored by:   ONONDAGA COUNTY SNOWMOBILE ASSOCIATION INC.   In support of New York’s SNOWMOBILE TRAILS NYS Identification Number: 31-215-850-08920 Raffle License # 15326 – Drawing held April 26, 2014

  ‐‐‐ Ticket Stub & Payment RETURN Form ‐‐‐  To be used by NY Snowmobile Clubs only   This form must be filled out COMPLETELY and ACCURATELY and SUBMITTED with your PAYMENT and TICKET STUBS to assure that your CLUB DOLLAR SHARE is EXPEDITED!

PLEASE PRINT CLEARLY Club Name ________________________________________________ NYSSA Club ID #_______________

Date _____________________________

Number of Tickets Enclosed________________ X $ 5.00 per Ticket = $ _______________Total Submitted

Payment Method ( Indicate One )

Check ______ Check #__________ or Cash _______

~ Do not mail cash, cash may only be submitted at the NYSSA Forum ~

Club Contact Name ______________________________________Title ______________________________ Contact Phone Number

Area Code ( _______ ) ________ - ____________

Contact Email Address (if possible) __________________________@ ______________________________

* * The deadline for submission is 12:00 Noon April 26, 2014 **  Make checks payable to the ONONDAGA COUNTY SNOWMOBILE ASSOCIATION and send to

ONONDAGA COUNTY SNOWM0BILE ASSOCIATION P.O. BOX 392 SYRACUSE NY 13215 Received by _______________________________________________


2014 super raffle ticket return form