This transcription has been completed. Contact us with corrections.
[[left margin]] June 17, 67 [[/left margin]] I, [[strikethrough]] LA Gallaway [[/strikethrough]] Peter Moore, a resident of Brunswick County, North Carolina, am personally acquainted with Mary Moon (colled) widow, 3 small children and entirely destitute, who reside in Brunswick County, North Carolina, and state, to the best of my knowledge and belief, that she is entirely unable to maintain herself & family 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. [[strikethrough]] LA Gallaway [[/strikethrough]] Peter Moore {Seal} Sworn and subscribed to before me, this 19 day of June, 1867 [[strikethrough]] Wm R Dothers JP [[/strikethrough]] W Lyman Capt US Inft Comdg fort Note. - This Certificate must be signed and sworn to before some officer or agent of this Bureau.