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I, Lewis A Galloway, a resident of Brunswick County, North Carolina, am personally acquainted with Lerania 
 Gren, 5 children children who is destitute, who reside in Brunswick County, North Carolina, and state, to the best of my knowledge and belief, that they are Entirly unable to maintain themselves and no friends to assist them and are worthy of charity form the government, and is in danger of starvation if relief is not given.
Lewis A Galloway {seal}

Sworn and subscribed to before me, this 19th day of June, 1867
W. R. Doshen, I. P.
Note.-This certificate must be signed and sworn to before some officer or agent of this Bureau.