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[[preprinted]]
[[underline]] No. 40. [[/underline]]
SPECIAL REQUISITION

For [[/preprinted]] Six Recruiting Flags

Approved
Jacob F. Chur
Actg. Asst. Adjt. Genl
In absence of Asst Comr
[[double line]]

[[preprinted]]
I CERTIFY that the above requisition is correct; and that the articles specified are absolutely requisite for the public service, rendered so by the following circumstances: [[/preprinted]] For offices of Sub Asst. Commissioners of State of North Carolina

Thos. P. Johnston
[[1st?]] Lt. Col. Chf QM & DO
State of NC

[[preprinted]]
[[blank line]] Quartermaster, U. S. Army, will issue the articles specified in the above requisition.

[[blank signature line]]
Commanding.

RECEIVED at [[blank line]] the [[blank line]] of [[blank line]] , 186 [[blank space]] ,
of [[blank line]] Quartermaster U. S. Army, [[blank line]] in full of the above requisition.
[SIGNED IN DUPLICATE]
[[blank signature line]]
[[/preprinted]]