Permanent Address: RFD #1, Mitchellville, Tenn
Age: 23
Date of Birth: August 2, 1893
U. S. Citizen: Natural Born
Where were you born: Mitchellville, Tenn, USA
What is your present occupation: Farming
By Whom Employed: Mandy Dinning
Where employed: Mitchellville, Tenn
Have you a father, mother, wife, child under 12, or a sister or brother under 12, solely dependent
upon you: Mother
Married or /Single: Single
Race: Caucasian
Signature: Robert Leslie Lovell
Registrar's Report
Remarks: __? __? state as to dependent.
Date of Registration: June 5, 1917
Tall, Medium or Short: Tall
Build: Slender
Color of Eyes: Brown
Color of Hair: light Brown
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