Permanent Address: R2, Hendersonville, Tenn

Age: 27

Date of Birth: July 25, 1889

U. S. Citizen: Natural Born

Where were you born: R2, Hendersonville, Tenn, U.S.A.

What is your present occupation: Farming

By Whom Employed: Myself

Where employed: R2, Hendersonville, Tenn

Have you a father, mother, wife, child under 12, or a sister or brother under 12, solely dependent upon you: Wife & two children

Married or /Single: Married

Race: Caucasian

Signature: Luther Dugger

Registrar's Report
Tall, Medium or Short: Medium
Build: Slender
Color of Eyes: Lt. Blue
Color of Hair: Black

Remarks: Blank

Date of Registration: June 5, 1917