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[Form 4.]

War Department,
Bureau of Refugees, Freedmen, and Abandoned Lands,
OFFICE CHIEF DISBURSING OFFICER,
Washington, D.C., June 29th 1870

RM Manly
Supt of Ed
Richmond Va

Sir:
Enclosed please find my Check No. 1513, on the [[strikethrough Assistant [[/strikethrough]] US Treasurer at Washington for $240.00/100 to pay the following Vouchers, viz:

W R. Brownlee SH & Asy 150.00 ✔
A B. Corlis SH & Asy 90.00-
$240.00

Very Respectfully, Geo W. Balloch
Bvt. Brig.- Gen. & Chief Dis. Officer.
per B.