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Office Asst.Supt. Greenville Dist.
Bureau R.F. and A.L.
Greenville Feb. 13th 1867

Lt. J. F. Conyngham,
A.A.A. General

Lieutenant
I have the honor to apply for a blank record, to be used for recording my complaints of Freedmen reported at this office. One of his quires will be sufficient.

Very Respectfully
Your obt. Servt.
Sam S. Gardner
Asst.Supt.