Permanent Address: Portland, Sumner, Tenn.

Age: 18

Date of Birth: Aug 28, 1900

Race: White

U. S. Citizen: Natural Born

Present Occupation: Laborer _ Mfg.

Employer's Name: Hanley Bradford

Place of Employment or Address: Nashville, Davidson, Tenn

Nearest Relative: Melody Goostree, Portland, Sumner, Tenn

I affirm that have verified above answers and that they are true:
Glivers Harrison Goostree
his
X
Mark

Registrar's Report
Height: Medium
Build: Medium
Color of Eyes: Grey
Color of Hair: Dark

Remarks: Blank

Date of Registration: Sept 12, 1918