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Bureau of Refugees, Freedmen, and Abandoned Lands.
THE UNITED STATES,
To A~ B. C~ Dr.

[[4 columned table]]
| 1869 |   | DOLLS. | CTS. |
| --- | --- | --- | --- |
| April 30 WASHINGTON, D.C. | For Services as Clerk to the Supt of Education Bureau R.F and AL for the State of  from April 1st to April 30th 1869 inclusive - one month at one hundred dollars per month. | 100 | 00 |
| April 30 WASHINGTON, D.C. | Less Int Rev Tax. |   | 83 |
| April 30 WASHINGTON, D.C. | $ |   |   |
| April 30 WASHINGTON, D.C. | Ninety-Nine 17/100 Dollars, | 99 | 17 |

I CERTIFY ON HONOR that the above account is correct and just that the services were rendered and stated and necessary for the public service. 

Approved and ordered and paid. Supt of Education State of

Bvt. Maj.-Gen., U.S.A. Commissioner.

Received, at Washington D.C., this ... day of ... 18 , from Bvt. Brig.-Gen. GEORGE W. BALLOCH, Chief Disbursing Officer, 
Ninety nine Dollars and seventeen Cents, in full of the above account by Check No. ... on the United States Treasury, dated ... 18 .

[SIGNED IN DUPLICATE.] A ~ B ~ C