serial # 8661 order # A97
Joseph Henry Thurman JACKSON
address - Ashburn, Loudoun, Va
age - 18
d.o.b.- November 4, 1899
Negro
occ - Laborer
employer - T.F. Galloway

Ashburn, Loudoun Va
nearest relative - Susan Ann Jackson mother

Ashburn Loudoun Va
signed - Joseph Henry Therman Jackson

(note - his signature - spelling of Therman - is different from the way the card was filled out by whoever was filling in the information)