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Bureau of Refugees, Freedmen & Abandoned Lands,
Headquarters Sub-Division of Warren,
Henderson, N.C., [[blank]] 1868.

HAY, THOS. H
1st. Lieut. 42nd Infantry, U.S.A.,
A.S.A. Com'r. 

Enclosures,
Received

Received of W H Davis 10th April 1868 as follows

Princl & Int 73.44 
Fee & Com 2.83 
Expenses for wagon 3.00
79.27

W A Philpott Shff
By A H Cooke Dep Shff  

Enclosures, [[blank line]]
Received [[blank line]]