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[[left margin]] June 19, 67 [[/left margin]]
Fort Johnson NC June 19 1867
I, [[strikethrough]] LA Gallaway [[/strikethrough]] Henry Pearce, a resident of Brunswick County, North Carolina, am personally acquainted with Sopiah Moore widow with 2 childnre who is unable to support destitute, who reside Brunswick County, North Carolina, and state, to the best of my knowledge and belief, that she unable to maintain herself & family and has no friends to assist is and is worthy of charity from the government, and   in danger of starvation if relief is not given.
Henry Pearce {Seal}
Sworn and subscribed to before me,    this 19th day of June, 1867

[[strikethrough]] Wm R Dosher JP [[/strikethrough]] W Lyman Capt 40th US Infy Comdg Fort

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