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

On the 28th day of September 1865 before me the undersigned a Notary Public in and for the City of Norfolk in the State of Virginia, duly authorized to administer oaths for general purposes in said City, personally appeared [[strikethrough]]before me[[/strikethrough]] Frank A Walke, who being by me first duly sworn doth [[strikethrough]]and[[/strikethrough]] depose and say, that he has read the proclamation of the President of the United States of the 29th day of May 1865, by which certain immunities and privileges are extended to those engaged in the late rebellion against the Govt. of the United States, and excepting certain classes of persons set forth and enumerated in the said proclamation, and that the case of the said deponent is not embraced in any of the exceptions therein contained as he verily believes.
F.A. Walke
Subscribed and sworn to before me this 28th day of Sep. 1865.
Simon S. Stubbs
Notary Public
[[stamp]]
U.S.
INTER. REVENUE
5 5
FIVE CENTS
5 5
INLD. EXCHANGE
[[/stamp]]