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Fort Johnson Smithville N.C. June 19, 1867

I, Samuel Freeman, a resident of Brunswick County, North Carolina, am personally acquainted with Frank Haut a destitute, Freedman who resides
in Brunswick County, North Carolina, and state, to the best of my knowledge and belief, that he is unable to maintain himself and has no friends to assist him and is worthy of charity from the government, and is in danger of starvation if relief is not given.

Samuel Freeman (SEAL)
Sworn and subscribed to before me, NLyman Capt W of US Infy this 19th day of June, 1867 
N Lyman Capt W of US Infy
Comes York

NOTE: This Certificate must be signed and sworn to before some officer or agent of this Bureau.