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File#  ________ _

                                                                                       Restriction:  Yes  / No






                                                         P.O.  Box 875
                                                    Newhall, California 91322




                    The  Board  of  Directors  of  the  Santa  Clarita  Valley  Historical  Society  gratefully  acknowledges  receipt  of  the
                  following items donated by:

                   Name:   m✓u  2:naa,ern                                            Phone: ________ _

                  Address: ______________________________________ _

                                                         Description                    Additional Info
                                                      1€ J  VJ '  /.I  /I
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                                                     (  ,,..,. c v-  l  y.::-,.,  ....v'"" ,·ts
                                                          ...                            .! r o i1  f  k  ,,.14/r-,s
                                                        .t..
                                                     IC.,.)  X   1 '/.,  '1
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                      lv v..._'c./ c- 1-'l   '7 l'·c. ..  11  /;l                         a,.,_,_.,   h4, p
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                                            Received this  ~ day of  -1.-'6 .... h--f _____________ ,  19 .£;.L.

                                             By: 4 c-=®  ,&' )i.'" ,,.e..1(-+<        •   [  ,. .-.i ➔ ,,,:
                                                                                                 (Office)
                                            for the Board of Directors~Clarita Valley Historical Society.

                    I hereby give and bequeath the above stated  items to the Santa Clarita Valley Historical Society with full power to
                  use,  reproduce or dispose of as determined by the Society's Board of Directors. Restrictions, if any, on the Society's
                  usage of the above items shall be set forth on the reverse hereof, dated and signed by Donor.


                  Date: _____________ _                    Donor: ____________________ _
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