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Collection: Original Records > Grass Valley Orphan Asylum

Record of Orphans Half-orphans and Abandoned Children (1900-1914 & 1929) (243 pages)

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s aid been given heretofore? If so, by whom? ho has charge and control of said childAcé ite fully reasons why childAusmZ dependent yw long will the childs¢44~..remain dependent? Signature of Applicant 1. Only parent. guardian or officer knowing the facts should sign this application i 2. Parent, estate, guardian, relatives, should aid in the support of child if possible, living parent, especially the father, is expected by to pay for maintenance of child. CERTIFICATE OF APPLICANT LAA BAM. If AF certify that I have made the answers after the questions above set férth; that after making said answers, the said questions and 3s were read to me and then I signed the same; that said answers are true and correct to the best knowledge, information and belief. bseribed to this......A4,Z4...............day of... Applicant. if Uf 4 WY Funiytig “ON