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No. 40. SPECIAL REQUISITION. [[3 columned table]] | | Form | | | --- | --- | --- | | (40) forty Blanks | No 2 | Application & Receipt Rolls | | (10) ten Blanks | No 2 | Report of Persons & Artcles hired | | (40) forty Blanks | No 22 | Vouchers | | (20) twenty Blanks | No 11 | Vouchers for Services rendered as Agt B.R. &c | | (30) thirty Blanks | No 17 | Vouchers for expences incured for transportation | | (10) ten Blanks | No 4 | Abstract for provisions issued | | (10) ten Blanks | No 5 | Statement of provisions issued | | (15) fifteen Blanks | No 15 | Monthly return of Stores Bureau &c | | (10) ten Blanks | No 40 | Special requision | | (6) six Blanks | No 3 | Requisition for Suplies, for distribution under Act of Congress Approved March 30/67 | [[/table]] [[stamp]] THE NATIONAL ARCHIVES OF THE UNITED STATES [[/stamp]] I Certify, That the above requisition is correct; and that the articles specified are absolutely requisite for the public service, rendered so by the following circumstances: For use of Bureau R F & A L Office Cartersville Cass County Geo, C.B. Blacker, Agt Bureau &c [[blank]] Quartermaster U.S Army, will issue the articles specified in the above requisition. [[blank]] Commanding. RECEIVED, at [[blank]] the [[blank]] of [[blank]] 186 of [[blank]] Quartermaster, U.S. Army [[blank]] in full of the above requisition. (SIGNED IN DUPLICATE.) C. B. Blacker, Agt, Bureau, &c,
&c = etcetera
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