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Form No. 2.
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To be dated and signed by the Claimant in person and returned forthwith. Signatures, if made by mark (x), must be witnessed by two persons who can write their names. 
[[stamp]] THE NATIONAL ARCHIVES OF THE UNITED STATES [[stamp]]

Sir:
I hereby acknowledge the receipt this day of 100 Dollars, pay in  check no -by US Express   
being the amount of duplicate vouchers heretofore signed by me for money due upon 2d Auditor's Certificate No. after deduction of legal charges of my Attorney. 
Yours respectfully, 

Late  Co.  Reg't, U.S.C.T.
SIGNED IN PRESENCE OF


To Col. F.A. SEELY,
Disbursing Officer, Bureau R.F. and A.L. 
ST. LOUIS, MO.