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I, Wm M Young, a resident of Hanover County, N.C., am personally acquainted with Mrs A A Stovall, who is in a destitute condition, who resides in Wilmington Hanover County, N.C., and state, to the best of my knowledge and belief  , that she is unable to maintain herself & family and has no friends to assist her, and that she is  worthy of charity from the government.

Wm M Young   {Seal}

Sworn and subscribed to before me,  , this   day of  , 1866.
Note. - This Certificate must be signed and sworn to before some Magistrate, Justice of the Peace, or officer of the army.