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Bureau Refugees, Freedman &c.
Hd. Qrs. Asst. Commissioner
Baltimore, Md. Sept. 28,1866

Personally appeared before me, F. G. Harman, who, being duly sworn, says that he is a resident of Ann [[Anne]] Arundel County, Md. 
and that the within statement is true.

Edwd. C. Knowen
Capt V.R.C.
A.A.A.G.

M460
[[stamp]] The National Archives of the United States [[/stamp]]

Transcription Notes:
Numerous items I could not read. (Anne Arundel is correct spelling though written as Ann)