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Fort JohnsonHuntsville N.C. June 19, 1867

I, Samuel Freeman, a resident of Brunswick County, North Carolina, am personally acquainted with Serrera Dozur colored who has three children & no husband present is  destitute, and who resides  Smithville Brunswick County, North Carolina, and state, to the best of my knowledge and belief, that she is unable to maintain herself and 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.

Samuel Freeman (SEAL)
Sworn and subscribed to before me,  Infy this 19th day of June, 1867

N Lyman Capt 20th  US Infy
Comdg Fort
NOTE — This Certificate must be signed and sworn to before some officer or agent of this Bureau.