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[[preprinted]] 416 [[/preprinted]]

D.C. &c.
May 21st

Bvt. Brig. Genl. H. M. Whittelsey
A. A. A. General.

General:
I have the honor to request that an appropriation of two hundred and fifty dollars ($250.) be made to aid in building School House at Salem, Queen Anne Co. Md. I enclose deed of School lot.

Very Respectfully
Your Obedient Servant,
[[signature]] W. L. Van Derlip [[/signature]]
Bvt. Maj. & Supt. of Education