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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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by whom? 4 ‘ = 4A ui c < 3 . ate Reese / ~~ hild Atv Le 17. Has aid been given heretofore? If so, by whom? d : ¢ 3 é: _ AN ffl ibid Eantane/ 18. Who has charge and control of said child at present time? Pay Ag 19. State fully reasons why child : dependent eee e iin dependent? .« aera Mp hettd VA, TE 20. How long will the child remain dependent ? Wnt é j : 4 A me CLOdL fee LL. a: ree) >, living parent, especially the father, is expected by Signature of Applicant MP? Note 1. Only parent, guardian or officer knowing the facts should sign this application. . ; : Note 3. Only parertate, guardian, relatives, should aid in the support of child if possible, living parent, especially the father, is expected by the State to pay for maintenance of child. [FICATE OF APPLICANT J, Lt ok OM Feats “gate, Es. ~..certify that I have made the answers CERTIFICATE OF APPLICANT th; that after making said answers, the said questions and oe oS od the same; that said answers are true and correct to the best YU 4 a tinea Fees ie ; certify that I have made the answers written after the questions above set forth; that after making said answers, the said questions and y answers were read to me and then I signed the same; that said answers are true and correct to the best day of. a 1924 of my knowledge, information and belief Z , Rok r PF gary ach Subscribed to this. a day of 7 194 ¢ ttt ets Applicant. ul ad JO proooy JO WOISSIUIpe IOz jo woryeoryddy a Ka LAO GATT WY wuniytag UOTSSIU Vdd