Permanent Address: RFD No3, Gallatin, Sumner, Tenn

Age: 38

Date of birth: May 16, 1880

Race: White

U. S. Citizen: Native Born

Present Occupation: Laborer

Employer's Name: Du Pont Co.

Place of Employment: Jacksonville, D?, Tenn

Nearest Relative: Bettie Payne, RFD No3, Gallatin, Sumner, Tenn

Description of Registrant:
Height- Tall
Build- Medium
Color of Eyes- blue
Color of Hair- Black

Date of Registration: Sept. 12, 1918