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State of NC
Davie County

This day Personally appeared before me Eliza Ann Gaither who after being duly sworn states that Milton Gaither furnished to Nancey + her family which consisted of herself & eight children during the year 1865 - with House firewood rations Dr Bills and good &sufficient clothes shoes stockings & c - all that was necesary to make them comfortable - and also gave Nancey & family about Twenty gallons of molases - Two Bushels Peas a quantity of Tobacco & dried fruit. Eliz ann Gaither

Duly sworn to subscribed before me this 12th May 1866

C Anderson