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Bureau of Refugees, Freedmen, and Abandoned Lands.

The United States,

To James M Jordan    Dr.
[[4 Columned Table]]
| 1870 |   | Dolls. | Cts. | 
| --- | --- | --- |

| Washington, D.C. | For rent of a House at Hayneville Lownds County now, occupied as a Freedmen's School from 1st Feb, 1870 , to 1st March, 1870 , inclusive, being one month days, at Ten dollars a month. |   |   |

|   | /100 Dollars, | 10. | 00 | 

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

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. 

___Leave this blank____
Supt. Education, State of 
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,____Ten___  dollars and  ____ cents, in full of the above account, by Check No._____  on _____, dated 18__  . 

[SIGNED IN DUPLICATE.]
S J M Jordan