Permanent Address: White House, Tenn
Age: 21
Date of Birth: Oct 28, 1895
U. S. Citizen: a Natural Born
Where were you born: Robertson Co., Tenn
What is your present occupation: Farming
By Whom Employed: Self
Where employed: Sumner Co, Tenn
Have you a father, mother, wife, child under 12, or a sister or brother under 12, solely dependent
upon you: Wife
Married or /Single: Married
Race: White
Signature: Herman Holman Cole
Registrar's Report
Remarks: No
Date of Registration: June 5, 1917
Tall, Medium or Short: Medium
Build: Medium
Color of Eyes: Blue
Color of Hair: Light
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