Permanent Address: R1 Hendersonville, Sumner, Tenn.

Age: 41

Date of Birth: Jan 25, 1877

Race: White

U. S. Citizen: Natural Born

Present Occupation: Farmer

Employer's Name: Self

Place of Employment or Address: R1 Hendersonville, Sumner, Tenn

Nearest Relative: Pearl Bloodworth, R1 Hendersonville, Sumner, Tenn

I affirm that have verified above answers and that they are true:
Albert Bloodworth

Registrar's Report
Height: Tall
Build: Slender
Color of Eyes: Lt. _?
Color of Hair: Lt. brown

Remarks: Blank

Date of Registration: Sept 12, 1918