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Report in compliance with Par. 2, Circular No. 18 C.S. Asst. Comr. Off. Va. of all persons, either white or colored, who require and are unable to provide the necessary corn and other seed for planting.

[[10 Columned Table]]
| Name | Sex | Age | Race White | Race Colored | No family under 21 years of age Male | No family under 21 years of age Female | Quantity of Land to be Seeded No Acres | Quantity of Land to be Seeded Quantity of Seed | Remarks |
| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |

I certify that the above Report is correct.

J.B Clinton
Lieut. & Asst. Supt.
Dinwiddie Co. Va.