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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 Becky [[Eves?]] widow with 4 children destitute, who reside Brunswick County, North Carolina, and state, to the best of my knowledge and belief, that she is unable to maintain herself & children 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 20 day of June, 2867
W Lyman Capt 20th U.S. [[??]] 
NOTE. - This Certificate must be signed and sworn to before some officer or agent of this Bureau. [[??]]