Permanent Address: Portland, Sumner, Tenn.

Age: 32

Date of Birth: November 19, 1885

Race: White

U. S. Citizen: Natural Born

Present Occupation: Carpenter

Employer's Name: ___ (?) Cook

Nearest Relative: Neeley Faullin, Portland, Sumner, Tenn.

I affirm that have verified above answers and that they are true:
John Roy Faullin

Registrar's Report
Height: Med
Build: Med
Color of Eyes: Brown
Color of Hair: Brown

Remarks: Blank

Date of Registration: Sept 12, 1918