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Hotel
Bureau of Refugees, Freedmen, and Abandoned Lands.
The United States, To Henry C. Cabell. Jas. H. Grant. Alex Wesst, and Henry Brid
To [[strikethrough]] Cabell &Co [[/strikethrough]]Dr. 

[[4 Columned Table]]

| Date |   | Dollars. | Cents. |

| --- | --- | --- | --- |

| 1870 | For one (1) Brick Building (here state dimensions) situated on certain real estate in Richmond Va., owned by Simmons &Co. and held by them for educational purposes, described as follows, viz:
............. The said building being adapted to and designed for the education of Refugees and Freedmen |   |    | 
/100 Dollars,

I CERTIFY, ON HONOR, that the above amount is correct and just; that the [[strikethrough]] services were rendered as stated, and were necessary for the public service. [[/strikethrough]] Building has been accounted for on my property returns for the month ending on the ... of ... 1870

Approved and ordered paid.  
Supt. Ed. B.RF&AL. 
For the State of Virginia

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, .... dollars and ... cents, in full of the above account by Check No. ... on the ..., dated .... 18 .

[SIGNED IN DUPLICATE.]