46
North Main St., San Andreas, California
RESEARCH REQUEST:
Date of Request: __________________
Received By: _________________________
How Received:
Personal Visit _____ Letter _____ Phone Call_____ Other
__________________________
Person or Organization Making Request:
Name ____________________________________________ Phone (_____) _______________
Address ______________________________________________________________________
City _________________________________ State ____________________ Zip Code ______
E-Mail Address: ___________________________________
Subject of
Research:
Person(s), Places, Historical Incident(s), etc. Give a brief background of persons or
families about whom you are inquiring.
Include all names, dates, names of towns, etc. which will aid our staff
in locating data.
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
AGREEMENT:
It is my understanding that the charges for the above research are
$10.00 per hour plus the cost of copies and mailing. Upon receipt of the above information, I will provide my
remittance of the amount shown below to the Calaveras County Archives within a
reasonable period of time.
I WISH TO LIMIT THE AMOUNT CHARGED FOR RESEARCH TO $_________________
SIGNATURE: ___________________________________________________________________
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THIS SECTION TO BE COMPLETED
BY STAFF MEMBER PERFORMING RESEARCH
Research Performed By:
__________________________________
Date: _____________________
Time spent on Research: _________________________________ Total Hours:
_______________
Charges: Return To:
________ Hours (X) $10/hr: _______________ Lorrayne Kennedy, Archivist
______ Copies (X) $0.25/cp: _______________ Calaveras County Archives
Postage & Handling: _______________ P.O. Box 1281
Amount Due: $ _______________ San Andreas, CA 95249
Open
Monday, Thursday and Friday, 8:30 a.m. to 4:30 p.m.
Phone:
(209) 754-3918
