Age in years: 21

Home Address: Cotton Town R.R-1, Tenn

Date of birth: Oct 23, 1896

Where were you born?: White House, Tenn

I am A Native of the United States

Father's birthplace: Sumner Co., Tenn

Name of employer: A. D. Latimer

Place of employment: Cotton Town, Tenn

Name of nearest relative: A. D. Latimer, Cotton Town, Tenn

Race: White

Registrar's Report
Medium, Slender
Color of Eyes- Brown
Color of Hair- Dark Brown

Date of Registration: June 5, 1918