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WAR HISTORY COMMISSION
STATE OF VIRGINIA
MILITARY SERVICE RECORD
Name in full
(family name): Johnson
(first name): Samuel
(middle name): T.
Date of birth
(month): Nov.
(day): 15
(year): 1889
Place of Birth
(town): Derry Station
(county):
(state): Penn
(country):
Name of father:
Birthplace (country):
Maiden name of mother:
Birthplace (country):
Are you White, Colored, Indian or Mongolian:
Citizen (Yes or no):
Voter (yes or no):
Church (denomination):
Married:
year:
at:
To (maiden name):
Born:
year:
at:
Children
(name):
Born:
year:
at:
Children
(name):
Born:
year:
at:
Children
(name):
Born:
year:
at:
Fraternal Orders:
College Fraternities:
Previous military service or training:
Education
(Preparatory): High School
(College):
Education
(University):
(Degrees):
Occupation before entry into service:
employer:
Residence before entry into the service
(street number):
(town):
(county):
Present home address
(street number): 35 Rodgers St.
(town): Bluefield
(county):
(state): W. VA
2
WAR RECORD
Inducted into service or enlisted on (date): June 29, 1918
at (place): Hopewell, VA
as a (rank): Pvt.
in the:
section of the :
Identification number:
Assigned originally to
(company): Bat. C
(regiment): 1st VA
(division): F.A.
(or)
(ship):
at (place):
Trained or stationed before going to Europe:-
School, camp, station, ship:
From (date):
to (date):
School, camp, station, ship:
From (date):
to (date):
School, camp, station, ship:
From (date):
to (date):
Transferred to:-
Company: Bat. C
Regiment: 111th
Division: F/A.
Ship:
Date:
New Location:
Company:
Regiment:
Division:
Ship:
Date:
New Location:
Company:
Regiment:
Division:
Ship:
Date:
New Location:
Promoted:-
From (rank): Pvt.
to (rank): Cpl.
Date: Feb. 1918
From (rank):
to (rank):
Date:
Embarked from (port):
on (ship):
(date):
and arrived at (foreign port):
(date):
Proceeded from :
to:
(date):
From:
to:
(date):
From:
to:
(date):
Trained or stationed abroad:-
Country:
Place:
From (date):
to (date):
Country:
Place:
From (date):
to (date):
Country:
Place:
From (date):
to (date):
