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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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Page: of 243
——%
17. Has aid been given heretofore? If,so, by whom?
18. Who has charge and control of said child at presént time?
19. State fully reasons why child dependent
.
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20. How long will the child remain dependent?
Signature of Petitioner
NOTE. State aid is for temporary relief only and must be stopped by the Board of Supervisors and the Board of Control when the necessity
ceases under which the application is allowed
STATE OF CALIFORNIA )
County of
I, solemnly swear or affirm, that I have made
the answers written after the questions above set forth; that after making said answers, the said questions
and answers were read to me and then I signed the same; that said answers are true and correct to the best
of my knowledge, information and belief.
Petitioner.
Subscribed and sworn to before me this . Leh day of Satis 19 oa
a Clerk.
By Deputy Clerk.
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