Permanent Address: R2, Cottontown, Sumner, Tenn

Age: 42

Date of birth: May 15, 1876

Race: White

U. S. Citizen: Native Born

Present Occupation: Farming

Employer's Name: C. H. Lind?

Place of Employment: R2, Cottontown, Sumner, Tenn.

Nearest Relative: Eular? Payne, R2, Cottontown, Sumner, Tenn

Description of Registrant:
Height- Tall
Build- Stout
Color of Eyes- blue
Color of Hair- black

Date of Registration: Sept. 12, 1918