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[[preprinted]]
[[boxed]]
WILL BLANK
... The Bladensburg Union...
Bladensburg, Md. [[/preprinted]]

^[[August 1st]] 19 ^[[38]].

^[[Will Blank of Daniel Fortune]] [[strikethrough]] hereby [[/strikethrough]] request that One Hundred Dollars (100.00) furnished by the Bladensburg Union upon the death of an adult member for funeral expenses to be paid to [[strikethrough]] my [[/strikethrough]] ^[[Daisy Fortune or H A Dunningto]] 
(Relative [[strikethroug]] or [[/strikethrough]] ^[[&]] Friend)

[[signature]] ^[[Hattie Dunnington]] [[/signature]]
(Name of Beneficiary) 

Philip Broome, Pres.
William E Burke, Sec.
[[/boxed]]
[[/preprinted]]

[[Circular seal, embossed twice]] 
THE BLADENSBURG UNION
FOUNDED 1870
MARYLAND 
[[/seal]]