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June 20, 67 
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Fort Johnston NC June 20 1867
I, L. A. Galloway, a resident of Brunswick County, North Carolina, am personally acquainted with Lavinia Green Widow with five children destitute, who reside in Brunswick County, North Carolina, and state, to the best of my knowledge and belief, that she is unable to maintain herself & family and has no friends to assist her and is worthy of charity from the government, and is in danger of starvation if relief is not given.

L. A. Galloway SEAL

Sworn and subscribed to before me,____________
this 20th day of June, 1867
W Lyman Capt 20th US Infy
NOTE. - This Certificate must be signed and sworn to before some officer or agent of this Bureau. Comdg Fort