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2 NO. 141. The United States, To........................Dr. [[four columned table]] |Date| |For actual cost of transportation of myself from.......... to.............as per annual statement| |Dolls.| |Cts.| [[/four columned table]] I certify that I performed the above journey for the purpose of entering upon my duties as Teacher in Freedmen's Schools at .......in the State of .............in accordance with the terms of my commission. I certify that ..............duly commissioned by......... has been transported from.....home in.......to.... .......where....is now employed as a teacher for....... at an actual cost for transportation-fares, procured at the lowest rates, and by the shortest practicable route at a cost of..........................dollars ($.....).100 .....................Agent. I certify on honor that the above named.................is a teacher of ............in the State of............. Approved and ordered paid} .............................}Supt. Education State of..... Asst. Commissioner.} Received at.......this.....day of.................186.. of..........the sum of.......dollars and.............cents in full of the above account.