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(Amount brot. forward - 876.02

[[8 columned table]]
| No | Name of Claimant | Co. | Regmt. | Kind of Claim | No of Certificate | Amt. paid Dolls | Amt. paid Cts | 
| --- | --- | --- | --- | --- | --- | --- | --- |

| 4 | Victoria ( Sister of Dick Prater)| "J" | 1st C.A.H | Back -Pay | 306,834 | 83 | 58 | 
| 5 | Polly - (Widow of) Emanuel McBee | "C" | 1st C.A.H | Back-Pay & Bounty | 380765 | 391 | 73 |
| 6 | Hannah - (Mother of) Willian Henry | "D" | 1st C.A.H | Bounty  | 344,434 | 285 | 97 |  
| 7 | Edward Wilson | "H" | 1st C.A.H | Bounty | 380,829  | 189 | 00 | 
| 8 | Alfred Mitchell | "F" | Bounty | 1st C.A.H | 418,899 | 189 | 00 |
| 9 | William Allen | "F" | 1st C.A.H | Bounty | 347,031 | 189 | 50 | 
| 10 | John Shay | "C" | 1st C.A.H | Bounty | 380,755 | 289 | 50 |
(Total paid out in month) $2,494.30

I certify that the above statement is true and correct,
Saml Walker 
Bvt. Capt. & S-A.C