Permanent Address: RFD3, Goodlettsville, Sumner, Tenn.

Age: 32

Date of Birth: March 28, 1886

Race: White

U. S. Citizen: Natural Born

Present Occupation: Farmer

Employer's Name: works for self

Place of Employment or Address: RFD3, Goodlettsville, Sumner, Tenn

Nearest Relative: James Bloodworth, RFD3, Goodlettsville, Sumner, Tenn

I affirm that have verified above answers and that they are true:
John Bloodworth

Registrar's Report
Height: Medium
Build: Stout
Color of Eyes: Black
Color of Hair: Black

Remarks: Blank

Date of Registration: Sept 12, 1918