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Know all Men by these Presents,
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THAT WE, [[blank]] of [[blank]] as principal and [[blank]] of [[blank]] as surety, are held and firmly bound unto the United States of America, represented by the Quartermaster's Department, [[blank]] in the penal sum of [[blank]] dollars, $ [[blank]] lawful money of the United States, well and truly to be paid if default be made to the condition of this obligation, and to which payment, so to be made, we, jointly and severally, bind ourselves, our Heirs, Executors, Administrators and assigns, each and all, by these presents.

Now the condition of this obligation is, that if all the provisions of the attached contract for [[blank]] which we hereby acknowledge as genuine and binding upon us both, shall be strictly fulfilled by the said [[blank]] then this the said obligation to be null and void, but otherwise to remain in full force and virtue.

And we, the said [[blank]] and the said [[blank]] do also certify on oath, that we execute this bond for the uses and purposes stated herein only, signing in triplicate, all as originals. I, the said [[blank]] the surety, specially deposing on oath, that I am personally worth over and above all obligations against me, the sum specified as bond money, on this obligation.

WITNESS.
[[blank]]
[[blank]] {SEAL.}
[[blank]] {SEAL.}

Sworn, subscribed to, and acknowledged, before me, a Notary Public, duly sworn and commissioned, this [[blank]] day of [[blank]] 186
[[blank]] Notary Public.

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