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[[stamp]] THE NATIONAL ARCHIVES OF THE UNITED STATES [[/stamp]]

Bureau of Refugees, Freedmen, and Abandoned Lands
THE UNITED STATES,

To J. G. Fowler     Dr.
[[4 columned table]]
| 1869  |   | DOLLS. | CTS. |
| --- | --- | --- | --- |

| June 30 WASHINGTON, D.C. | For rent of House #3 at Township 17 Range 6 Perry County Ala, occupied as a Freedmen's School from June 1st, 1869, to June 5th 1869, inclusive, being - month Five days, at Fifteen dollars a month. | 2 | 50 |
|   | Two and 50/100 Dollars, | 2 | 50 |

I CERTIFY, ON HONOR, that the above account is correct and just; that the building was occupied as stated, and was necessary for the public service. 

________________________
Supt. Education, State of Alabama
Approved and ordered paid. 
__________________________________________________
Bvt. Maj.-Gen., Commissioner of Refugees, Freedmen &c.

Received, at Washington, D.C., this ____ day of ___ 18__ , from Bvt. Brig.-Gen. GEORGE W. BALLOCH, Chief Disbursing Officer,___________  dollars and  ____ cents, in full of the above account, by Check No._____  on _____, dated 18__  . 

[SIGNED IN DUPLICATE.]
J. G. Fowler