San Francisco Relief Survey; the organization and methods of relief used after the earthquake and fire of April 18, 1906

by Unknown

First Name		Age	Occupa- tion	Earnings Per Week	Physical condition	Name	Address
						of Employer
Man
Woman
Children
Others in Family						Other References

Insurance: Amount?		Savings: Amount?
What companies?		Real Estate: Value?
		Other Property?
Attach two letters of reference.If possible one should be from a formerlandlord to whom you have paid rent for some time. If you are living in a permanentcamp, one letter must be from the Camp Commander.
(OVER)

Above form as [illustration]

[305] On the reverse side space was provided for answers to the following:

What sum do you ask from the Rehabilitation Committee?
State clearly the use to which you wish to put this money
State clearly what have been the circumstances that make this application necessary

CIRCULAR LETTER OF INQUIRY

F. W. Dohrmann,

Chairman

D. O. CROWLEY

O. K. CUSHING