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NARA 495 (No. 25.) Cert. No. __ CLAIMANT. __ Late __ Co.__ Regt. __ U.S.C.T. Amount due $ __ BY WHOM WITHDRAWN. __ OFFICE MARK. __ A.G.O.| F.B.| 187 .
Transcription Notes:
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Reopened for Editing 2024-05-28 09:43:28
Added NARA page
Fixed to reflect fill in form for readability.