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[[stamped]] The National Archives of the United States [[/stamped]]

The United States, 
To_____________________________Dr.

[[4 columned table]]
|---|---|---|---|

| Date | For actual cost of transportation of myself from__to__as per annexed statement. | Dolls. | Cts. |

I certify that I performed the above journey for the purpose of entering upon my duties as a Teacher in Freedmen's Schools at ___ in the State of ___ in accordance with the terms of commission. 

___ Teacher.

I certify that ___ duly commissioned by ___ has been transported from ___ home in to ___ where ___ is now employed as a teacher for ___ at an actual cost for transportation-fares, procured at the lowest rates, and by the shortest practicable route at a cost of ___  dollars ($___)

Edw P Smith Gen Field Agent.

I certify on honor that the above named ___ is a teacher of ___in the State of ___

Supt. Education State of ___

Approved and ordered paid. 

Assist. Commissioner.

Received at ___ this___ day of___ 186_ the sum of ___ dollars and ___ cents in full of the above account. 

Julia Wanzer