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[[preprinted]] 
Bureau of Refugees, Freedmen and Abandoned Lands,
Office Claim Agent & Ass't Sup't, Sub-District of New Berne,
New Berne, N.C. ^[[April 1st]] 1867. 
[[/preprinted]]

Lt. Col. Jacob F. Chur }
Act. Asst. Adjut. Gen. }

Colonel,

I have the honor to acknowledge the receipt of yours of the 30th inst enclosing Treasury Certificate No [[underlined]] 293,350 [[/underlined]]. for one hundred dollars ([[underlined]] $100 [[/underlined]]) the amount of claim against the U.S. of [[underlined]] William Simms late of Co "I" 5th Regt. U.S.C.T.  [[/underlined]] also his discharge papers.

I am very Respectfully
Your Obedient Servant
[[signature]] A. Coats [[/signature]]
1st Lt V.R.C & Bvt. Maj. U.S.V