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0873

State of Virginia } S.S.
City of Norfolk   }

On this 6th day of October 1865, before me the undersigned a Notary Public in and for the City aforesaid in the State of Virginia, personally appeared William S. Forrest, who, being by me first duly sworn, doth depose and say, that he has read the President's proclamation of the 29th May 1865, and that the case of the said deponent is not embraced in any one of the exceptions therein contained, as he verily believes.

W.S. Forrest.

Subscribed and sworn to before me the undersigned a Notary Public this 6th day of October 1865.  As witness my hand and seal of office.

Simon S. Stubb
Notary Public

[[stamp]] 5-cent internal revenue stamp with picture of G. Washington [[/stamp]]