serial # 1599 order # A 311
Ernest Linwood JACKSON
age - 42
perm home address - Leesburg Loud Virginia
d.o.b. - Aug 15 1776 ( this is obviously an error - should read 1876)
negro
present occupation - Farm Hand
Employer's Name - W.C. Gallehen (?) or Galleher
Leesburg, Loudoun VA
Nearest Relative - Rose Ann Jackson - wife
Leesburg Loud Virginia
Ernest Linwood Jackson (signature)