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United States of America
United States District Court District of Virginia
Clerks Office, Ss.

Norfolk, Va November 24, 1865

[[left margin]] $99.75/100 [[/left margin]]

Received of Mr Mathias Ward sum of Ninety Nine 75/100 Dollars -

(the same to be applied to the payment of the Costs in his cause viz. No. 43 United States vs. Mathias Ward)

W.H. Barry, Clerk
per R.C. Jones, Deputy.