Permanent Address: 4 Bethpage, Sumner, Tenn.

Age: 21

Date of Birth: Sept 26, 1897

Where were you born? Macon Co., Tenn, USA

U. S. Citizen: Natural Born

Father's birthplace: Macon Co., Tenn, USA

Name of employer: Dupant Eng. Co.

Place of employment: Hadleys Bend, Tenn

Nearest Relative: Mrs. Kate Cole, Hendersonville, Tenn

I affirm that have verified above answers and that they are true:
Booker B. Cole

Registrar's Report
Color of eyes: Borwn
Color of hair: Black

Remarks: Blank

Date of Registration: June 5, 1918