Form A

Eureka Heritage Society Survey

Files additional information and corrections

 

Address of Property:

 

 

Additions: Information being submitted for inclusion in a file, which may include official documents, letters, diaries, photos with captions and dates, family stories, letters, newspaper articles, first-hand knowledge, etc. (Include copies.)

 

Corrections:

1. Information in file believed to be incorrect:

 

 

 

2. Reason for doubting the information:

 

 

 

 

3. Source of knowledge (official documents, letters, diaries, photos,

family stories, newspaper articles, first-hand knowledge, etc.).

 

 

 

 

Your name:

Address:

Phone number & e-mail :

Date of submission of form:

 

 

 

 

 Print this page from your browser, then fill out and Put form and added information in envelope and send it to:

Eureka Heritage Society

P.O. Box 1354

Eureka, CA 95502

 

November 2008