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Bureau RF and AL 
Office Sup't 3d Dist
Richmond Va Mar 29th/67

Respectfully forwarded to Bv't Brig Gen'l O Brown Assist Commiss'r State of Va "Approved" 
James A. Bates
√ Cap't 43d Infty and Sup't 

[[stamp]] STATE OF VIRGINIA. BUREAU R. F. & A. L. *** RECD. HD. QRS. ASST. COMMISSIONER. MAR 29 1867 [[/stamp]]