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Form for Office Rect Bureau of Refugees, Freedmen, and Abandoned Lands. The United States, To James T Lewis D&. [[4 columned table]] |1869 | |Dolls.|Cts.| |---|---|---|---| |April 30 | For rent of building (or rooms) occupied as Offices by the Supt. of Education and Asst. Disbursing Officer, for the payment of Bounties, Bureau R.F. and A Lands at Richmond Va. from April 1" to April 30" 1869 - inclusive - one month at Seventy five dollars a month| 75| 00| |Washington, D.C.| $ | | | | |Seventy five 00/1-- Dollars,| | | [[\4 columned table]] I certify, on honor, that the above account is correct and just; that the [[strikethrough]] services were rendered [[\strikethrough]] building was occupied as stated, and [[strikethrough]] were [[\strikethrough]] was necessary for the public service. R.M. Manly Supt. of Education State of Virginia Approved, and ordered paid. Bvt. Maj.-Gen., U.S.A., Commissioner, Received, at Washington, D.C., this _ _ _ day of _ _ _ 18 , from Bvt. Brig.-Gen. George W. Balloch, Chief Disbursing Officer, Seventy five Dollars and -- Cents, in full of the above account, by Check No. _ _ _ on the United States Treasury, dated _ _ _ 18 . [Signed in duplicate] James T. Lewis