Permanent Address: R2, Portland, Sumner, Tenn

Age: 34

Date of birth: Oct. 19, 1883

Race: White

U. S. Citizen: Native Born

Present Occupation: Farming

Employer's Name: Self

Place of Employment: R2, Portland, Sumner, Tenn

Nearest Relative: Bettie Payne, R2, Portland, Sumner, Tenn

Description of Registrant:
Height- Tall
Build- Slender
Color of Eyes- Blue
Color of Hair- Brown

Date of Registration: Sept. 12, 1918