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AGENDA ITEM SUBMITTAL FORM BOARD OF Supervisors Clerk's Use Only: AGENDA NUMBERLESS OF THE BOARD 44 N. San Joaquin Street, Suite #627 Stockton, California 95202SUBMIT ONE COPY OF THIS FORM WITH EACH

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To fill out date 53113, follow these steps:

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Start by writing the month, which is May.

03

Then write the day, which is 31.

04

Finally, write the year, which is 2013.

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Make sure to use the correct format, with the month before the day and separated by slashes (05/31/2013).

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