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W. 99. Vol 1/69. R.F. and A.L. Va, 
Washington, D.C.
Aug 17/69

War Department, Bu; &c
by J.W. Alvord
Genl. Supt Schools.

States that 20 blanks (Ed. Form No. 6.) have this day been forwarded.

[[stamp]] STATE OF VIRGINIA. BUREAU OF R. F. & A. L. RECD. AUG 18 1869 [[/stamp]]