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[[left margin]] June 19, 67 [[/right margin]]
Fort Johnson NC June 19, 67
I, Amy Holden, a resident of Brunswick County, North Carolina, am personally acquainted with Anneke Nie with three children a destitute widow, who reside Brunswick County, North Carolina, and state,to the best of my knowledge and belief, that she is unable to maintain herself 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.
Amy L Holden [[SEAL]] 
Sworn and subscribed to before me,  N Lyman Capt US infy
this 19 day of June, 1867
M Lyman Capt 20th US infantry
[[footer]]  Note. - This Certificate must be signed and sworn to before some officer or agent of this Bureau.[[/footer]]
Comdg Fort