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Bureau of Refugees, Freedmen and Abandoned Lands, 
L.B. 36 Vol 1st 1867 Office Superintendent 3rd District [[strikethrough]] of Virginia [[/strikethrough]] Dept of Potomac
Richmond, Va., February 20 th 1867

Bvt Brig. Genl O. Brown A.A.A.G.
Bureau R.F. and A. Lands, Dept of Potomac
General,
I have the honor- to request that I be furnished with One hundred (100) copies of the enclosed Form.
Very Respectfully
Your Obed't Servt
James A. Bates
Capt 43rd Infty and Sup't

Form in Printers hands

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