Permanent Address: Mitchellville, Sumner, Tenn.
Age: 29
Date of Birth: Oct 19 1886
U. S. Citizen: Natural Born
Where were you born: Sumner Co., Tenn
What is your present occupation: Farming
By Whom Employed: H. A. Lovell
Where employed: Sumner, Tenn
Have you a father, mother, wife, child under 12, or a sister or brother under 12, solely dependent
upon you: No
Married or /Single: Single
Race: Caucasian
Signature: Shell Lovell
Registrar's Report
Remarks: Blank
Date of Registration: June 5, 1917
Tall, Medium or Short: Tall
Build: Slender
Color of Eyes: Blue
Color of Hair: Light
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