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Bureau Refugees, Freedmen, and Abandoned Lands,
THE UNITED STATES,
To William M Brooks ..... Dr
[[4 Columned Table]]
| 186 |   | Dollars | Cents. | 
| --- | --- | --- | --- |
|   | $ |   |   |

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

I certify, on Honor, that the above account is correct and just; that the services were rendered as stated, and were necessary for the public service._____________________________

Approved and ordered paid.

Received at ____ , this ____ day of ___ , 186__ , from ___ , _____  dollars and ____ cents, in full of the above account by Check No. ____  on the United States Treasury, dated _____ 186 ___  .

William M Brooks

[Signed in Duplicate.]

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