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NARA 750

Form 7.

We, the subscribers, do hereby acknowledge to have received, at _____ of Capt. C. R. Tyler, A.Q.M. U.S. Vols, Receiving and disbursing Officer, Freedmen's Bureau, State of Mississippi, the sums set opposite our names, being in full of our services for the time herein expressed, having signed duplicates hereof.  

[[15 Columned Table]]
| No. | Names. | Occupation. | Period of Service. From - | period of Service. To - | Rate of Pay. Dolls. | Rate of Pay. Cents. | Total Amount Due. Dolls. | Total Amount Due. Cents. | Stoppage. Dolls. | Stoppage. Cents. | Amount Received. Dolls. | Amount Received. Cents. | Signatures. | Witness. | 
| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |
| For the month of October 1866 | Geo. St. C. Hussey J. | Steward | Sept 1, 1866 | Oct 31, 1866 | 40 | 00 | 40 | 00 | - | - | 40 | 00 | Geo. St.C. Hussey Jr. | Geo. St.C. Hussey Jr.
| For the month of October 1866 | Geo. Washington | Nurse | Sept 1, 1866 | Oct 31, 1866 | 10 | 00 | - | - | 10 | 00 | Geo. Washington, his x mark | Geo. St.C. Hussey Jr.
| For the month of October 1866 | John, Culigan | Nurse | Aug 1, 1866 | Oct 31, 1866 | 10 | 00 | - | - | 10 | 00 | John Culigan, his x mark | Geo. St.C. Hussey Jr. |
| For the month of October 1866 | Jamima, Ricks | Nurse | Aug 1, 1866 | Oct 31, 1866 | 10 | 00 | - | - | 10 | 00 | Jamima Ricks, her x mark | Geo. St.C. Hussey Jr. |
| For the month of October 1866 | Parker, Matheny | Nurse | Sept 1, 1866 | Oct 31, 1866 | 10 | 00 | - | - | 10 | 00 | Parker Matheny, his x mark | Geo. St.C. Hussey Jr. |
| For the month of October 1866 | Eliza, Cocksrell | Nurse | Oct 1, 1866 | Oct 31, 1866 | 10 | 00 | - | - | 10 | 00 | Eliza Cockrell, her x mark | Geo. St.C. Hussey Jr. |
| For the month of October 1866 | Elizabeth Rainer | Cook | May 15, 1866 | Oct 31, 1866 | 10 | 00 | - | - | 10 | 00 | Elizabeth Rainer, her x mark | Geo. St.C. Hussey Jr. |
| For the month of October 1866 | Fanny, Matheny | Cook | Sept 1, 1866 | Oct 31, 1866 | 10 | 00 | - | - | 10 | 00 | Fanny Matheny, her x mark | Geo. St.C. Hussey Jr. |
| For the month of October 1866 | Hariet, Finly | Cook | Sept 1, 1866 | Oct 31, 1866 | 10 | 00 | - | - | 10 | 00 | Hariet Finly, her x mark | Geo. St.C. Hussey Jr. |
| For the month of October 1866 | Dick, Battle | Cook | Sept 10, 1866 | Oct 31, 1866 | 10 | 00 | - | - | 10 | 00 | Dick Battle, his x mark | Geo. St.C. Hussey Jr. |
| For the month of October 1866 | Sally, Killingsworth | Laundress | May 1, 1866 | Oct 31, 1866 | 10 | 00 | - | - | 10 | 00 | Sally Killingsworth, her x mark | Geo. St.C. Hussey Jr. |
| For the month of October 1866 | Hetlie, Houston | Laundress | June 18, 1866 | Oct 31, 1866 | 10 | 00 | - | - | 10 | 00 | Hetlie Houston, her x mark | Geo. St.C. Hussey Jr. |
| For the month of October 1866 | Marie, Segart | Laundress | Sept 1, 1866 | Oct 31, 1866 | 10 | 00 | - | - | 10 | 00 | Mary Segart, her x mark | Geo. St.C. Hussey Jr. |
| For the month of October 1866 | Sally, Thompson | Laundress | Oct 1, 1866 | Oct 31, 1866 | 10 | 00 | - | - | 10 | 00 | Sally Thompson, her x mark | Geo. St.C. Hussey Jr. |

Nov. 1st 1866
I certify that the above Receipt Roll is correct.
Approved and payment ordered:
___________ Assistant Commissioner, State of Mississippi
Geo. St.C. Hussey, M.D.
A.A. Surg F.R. in charge H. Hospital
Lauderdale, Mis 

Transcription Notes:
Unsure of one last name: Hendsey?