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I, James M Cowan, a resident of Brunswick County, N.C., am personally acquainted with Lucretia Cowan, a destitute freed woman, who reside in Brunswick County, N.C., and state, to the best of my knowledge and belief, that she is unable to maintain herself, and has no friends to assist her, and that she is worthy of charity from the government.
James M Cowan {SEAL}

Sworn and subscribed to before me, John D. Taylor J.P., this 14th day of July, 1866.
Jno. D. Taylor J.P. {seal}

NOTE.-This Certificate must be signed and sworn to before some Magistrate, Justice of the Peace, or officer of the army.