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Provost Marshal's Office Dist of Va.
Norfolk Va. May 20 1865
This is to certify that Samuel C. White aged 65 occupation Farmer residence Virginia has taken and subscribed the Oath and Parole required for a Loyal Citizen of the United States residing in a State [[?]] rebellion, or who has sympathized with the Seceding States
(Signed) G.F. Potter
Capt & Provost Marshall
[[stamp]] STATE OF VIRGINIA BUREAU OF R.F. & A.L. REC'D HD QRS ASST. COMMISSIONER MAR 7 1866 [[/stamp]]