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No. 12

The United States,

To . . . John Green . . . DR.

Date of purchase Nov 21st (57) Fifty Seven Bushels Corn
@ 60^c per Bushel

DOLLAR 34 CENTS. 20

The Owner of said property will
be entitled to be paid for the same after
the suppression of the rebellion upon proof
that he has from this date, conducted
himself as a loyal Citizen of the United
States, and has not given aid or comfort
to the Rebels.

I certify that the above account is correct and just, and that the articles have been accounted
on my property return for the quarter ending on the 30th of November 1862.

J. N. [?]
[?] Quartermaster.

RECEIVED at . . . . . , the . . . of . . . . . , 186 ,
of . . . . . Quartermaster U. S.
Army, . . . . . dollars and . . . . . cents
in full of the above account.
. . . . . . . . . .

(SIGNED IN DUPLICATE.)