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Before me personally appeared the undersigned Rose Hart and being duly sword deposes as follows.

My name is Rose Hart - I live in the City of Memphis Tenn., On the night of the 2" of May 1866 A party of men came to my house, and burned it and most all the contents therein.  My loss amounts to the sum of $75.00

Rose her X mark Hart

Subscribed and Sworn before me this the 11" day of May 1866

(signed)  M. Walsh
Capt & A.A.A. Genl
and Prov Mar Freedmen

True Copy
FWH Kendrick
Capt & A. I Genl