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I, , a resident of Wilmington, New Hanover County, N.C am personalth acquainted with Mary Riely and 4 children, who destitute and, who reside in Wilmington, New Hanover County N.C and state to the best of my knowledge and belief, that they are destitute and unable to maintain themselves and have no friends to assist them, and they are worthy of charity from the government.

A. Paul Repitore  {SEAL}

Sworn and subscribed to before me, James Shackelford, a Justice of the Peace, County aforesaid this 8th day of February, 1867.
J. Schackelford
NOTE. - This Certificate must be signed and sworn to before some Magistrate, Justice of the Peace or officer of the army.