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at large in this district from said 21st day of 1875 until the 1st day of February 1876 at the {burned page corner} of one thousand ($1, 000) dollars per annum amounting to the sum of one hundred and fifteen dollars ($115, 10/100). I have the honor to ask if I am authorized to pay this claim and to estimate for funds to pay the same.
Very respectfully
Your old Servant
William D Hare
Collector