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District of Columbia }
County of Washington } S.S.

On this 30th day of April A.D. 1867 Personally appeared before me the Subscriber a Justice of the Peace in and for said County and District George St. Clair Hussey who being by me duly Sworn on his Oath declares that he is the Identical George St. Clair Hussey who was employed in the Bureau of Refugees Freedmen & Abandoned Lands under the order of Dr. S.H. Horner as an Acting Assist Surgeon principally employed in ascertaining amounts due Attendants in Hospitals for Freedmen &c. &c. under the endorsed Instructions from said Bureau. And he further diposes that he entered on such duties on the 8th Day of December 1866 & continued in the faithful discharge of such duties until the 25 Day of March 1867, and therefore claims that there is due him for such services the Pay and all allowances of an