Изображения страниц
PDF
EPUB

is that of a

Applications for Pensions.

and they further state that they have no interest in the

[merged small][merged small][merged small][merged small][ocr errors][merged small]

hereby certify that I have no interest, direct or indirect, in the prosecution

of this claim.

[Official seal, if any.]

[Signature of magistrate.]

1139. Widow's Application for Army Pension.

[ocr errors]

[As in preceding form to the*, continuing thus:] doth on her oath make the following declaration, in order to obtain the benefits of the provision made by the act of Congress, approved July 14, 1862, granting pensions: That she is the widow of C. B., late of the county of and State of who was a [here designate rank-e. g., corporal, or, private] in Company [letter of company], commanded by [here give name of captain], in the Regiment of [here name State] volunteers, cavalry [or, infantry, or, artillery], mustered into the service of the United States from the State of in the war of 1861, and who died [or, was killed] at [here

[ocr errors]
[ocr errors]
[merged small][merged small][ocr errors][merged small][ocr errors]

verily believes. She further declares that she was lawfully married to the said C. B., at in the State of [by M. N., a clergyman, or other authorized functionary, on the day of 18 ]; that her husband,

[ocr errors]

the aforesaid C. B., died on the day above mentioned, as she verily believes, and she remained his faithful wife until his decease. She further declares that she has remained his widow ever since the death of her said husband [until the when she married again her present husband, all of which will more fully appear by reference to the proof hereto annexed]. † She further declares that she had, by said deceased husband,

being

day of of

[ocr errors]
[ocr errors]

child

now living, under the age of sixteen

years, named, aged and residing as follows:

[ocr errors][merged small]

in any manner, been engaged in, or aided or abetted, the rebellion in the United States, and that her maiden name was

[ocr errors]

[and she hereby appoints J. K., of her lawful attorney, to procure for her the pension mentioned in the above application, and to receive and receipt for any certificate which may issue in her favor in connection with the same, hereby ratifying and confirming whatever her said attorney may do in the premises].(c) My post-office address is [stating it].

[ocr errors][ocr errors]

[Signature of claimant.] ALSO personally appeared M. N. and O. P., residents of in the county of and State of , persons whom I certify to be respectable and entitled to credit, and who, being by me duly sworn, say that they were present and saw A. B. sign her name for, make her mark] to the foregoing declaration; and they further swear that they have known the parties above described to have lived together as husband and wife for years previous to and up to the time of deceased going into the aforesaid service of the United States, and they have every reason to believe, from the ap

(c) See preceding note.

Application by Guardian.

pearance of the applicant, and their acquaintance with her, that she is the identical person she represents herself to be, and that they have no interest in the prosecution of this claim.

SWORN to [etc., as in preceding form].

[Signatures of witnesses.]

1140. Guardian's Application on Behalf of Minor Children, for Army

Pension.

[As in Form 1138 to the *, continuing thus:] makes the following declaration, as guardian of the minor child of C. B. deceased, in order to obtain for the benefit of the act of Congress approved July 14, 1862, granting pensions to minor children under sixteen years of age, of deceased officers and soldiers. That he is the guardian of [naming the minor child or children, his ward or wards], whose father was a [here designate rank-e. g., corporal, or, private], in Company [letter of company], commanded by [here give name of captain], of the Regiment of [here designate State] volunteers, infantry [or, cavalry, or, artillery], in the war of 1861, † who died [or, was killed] at in the State of about the day of

[ocr errors]

on or

[here state the cause of death], while in the service aforesaid. That M. B., the mother of said child, was married to said [name the soldier], deceased, at

of

about the

day of

in the county of

and State

[ocr errors]

[by M. N., a clergyman, or other authorized functionary], on or day of

[ocr errors]
[ocr errors]

18 ; and that she died on or about the

18 ; and that he knows of no record evidence of said marriage [or if any, refer to it], and that § his said ward is not in the receipt of any pension under said act, or any other act [and he hereby appoints J. K., of his lawful attorney, and authorizes him to present and prosecute this claim, and to receive and receipt for any orders or certificates that may be issued in satisfaction thereof]. (d) My post-office address is as follows [stating it]. [Guardian's signature.]

[ocr errors]
[ocr errors]

and State of

[ocr errors]

ALSO personally appeared before me, M. N. and O. P., residents of in the county of to me well known as credible persons, who, being duly sworn, declare that they were present and saw said A. B. sign his name [or, make his mark] to the foregoing declaration; and that they believe, from the appearance of the applicant, and their acquaintance with him, that he is the identical person he represents himself to be; and know that said parents of said ward were recognized as man and wife, and so reputed in the community in which they resided; and that they have no interest, direct or indirect, in the prosecution of this claim.

SWORN to [etc., as in Form 1138].

[Signatures of witnesses.]

1141. Mother's Application for Army Pension.

[As in Form 1138 to the *, continuing thus:] doth on her oath make the following declaration, in order to obtain the benefit of the provision of the

(d) See note (b).

Application for Pensions.

act of Congress approved July 14, 1862. That she is the widow of C. B. deceased, and mother of [naming the soldier], who was [here state rank— e. g., a corporal, or, a private] in Company [letter of company], commanded by [here give name of captain], of the [number] Regiment of [here designate the State] volunteers, infantry [or, cavalry, or, artillery], in the war of 1861, † and who died [or, was killed] in the service aforesaid, at in the State

of

on or about the day of

[ocr errors]
[ocr errors]

18 of [here state the cause of death]. That her said son, upon whom she was wholly or in part dependent for support, left no widow, or minor child under sixteen years of age, surviving; and that she was married to said C. B. at

[ocr errors]

on or about the

[ocr errors]

day of

[ocr errors]
[ocr errors]

in the

State of 18 [by M. N., a clergyman, or other authorized functionary]; that she knows no record evidence of said marriage [or if any, refer to it]; that her said husband died on or about the day of 18; that she has not in any way been engaged in, or aided or abetted the rebellion in the United States; and that she is not in the receipt of a pension under the second section of the aforesaid act, or under any other act. Nor has she again married since the death of her said son. [She hereby appoints J. K., of her lawful attorney, and authorizes him to present and prosecute this claim, and to receive and receipt for any orders or certificates that may be issued in satisfaction thereof). My post-office address is as follows [stating it].

[ocr errors]

[Signature of claimant.]

ALSO personally appeared before me, M. N. and O. P., residents of

[ocr errors]
[ocr errors]

in the county of and State of to me well known as credible persons, who, being duly sworn, declare that they were present and saw said applicant sign her name to the foregoing declaration, and they believe, from the appearance of the applicant and their acquaintance with her, that she is the identical person she represents herself to be, and know that she was recognized by said C. B. as his lawful wife, and that she was so recognized by the community in which they resided; and that they have no interest, direct or indirect, in the prosecution of this claim. SWORN to [etc., as in Form 1138].

[Signatures of witnesses.]

1142. Guardian's Application on Behalf of Orphan Sisters, for Army

Pension.

[As in Form 1138 to the *, continuing thus:] doth on oath make the following declaration as guardian of the orphan sister of C. B., deceased, in order to obtain for her the benefit of the act of Congress, approved July 14, 1862, granting pensions to orphan sisters, under sixteen years of age, of deceased officers and soldiers. That he is the legally appointed guardian of [here give the name and age of each sister entitled], who is the only surviving daughter, under sixteen years of age, of C. B., and M. B. his wife, both deceased, and sister of [naming soldier], who was a [state rank—e. g., corporal, or, private] in Company [letter of company], commanded by [here give name of captain], of the [number] Regiment of regulars [or, volunteers, designating the State], infantry [or, cavalry, or, artillery], in the war of

[ocr errors]

Navy Pensions.

in the State of

[ocr errors]

1861, and who died [or, was killed] in the service aforesaid, and in the line of duty, at on or about the day of 18 [here state cause of death]. That said C. B., brother of his said ward, upon whom she is wholly or in part dependent for support, having left no widow, minor children, or mother, the claimant, as guardian and in behalf of said ward, refers to the accompanying evidence, and to such as may be found in the department, to establish this claim. He further declares that [continue as in Form 1140 from the § to the end].

II. NAVY PENSIONS AND PRIZE-MONEY.

1143. Invalid's Application for Navy Pension.

[As in Form 1138 to the*, continuing thus:] declares that he is the identical who enlisted in the naval service of the United States at

[merged small][ocr errors][merged small][merged small][merged small][merged small][ocr errors][merged small][merged small][merged small][ocr errors][ocr errors]
[ocr errors]
[merged small][ocr errors][merged small]

18 ; that he is

and was honorably dis

feet

height [light] complexion[sandy] hair [blue] eyes, and by occupation a [sailor]. [Continue as in Form 1138 from the † to the end].

1144. Widow's Application for Navy Pension.

[As in Form 1138 to the *, continuing thus:] doth on her oath make the following declaration, in order to obtain the benefits of the provision, made by the act of Congress approved July 14, 1862, granting pensions: That she is the widow of C. B., who was a in the United States navy, and on board the in the

killed] at

[ocr errors]

commanded by

[ocr errors]

who died [or, was

[here state the cause of death], on the day of

[ocr errors]
[merged small][ocr errors][merged small][merged small][merged small]

18 as this deponent verily believes. lawfully married to the said C. B. at in the State of clergyman, or other authorized fanctionary, on the day of that her husband, the aforesaid C. B., died on the day above mentioned, as she verily believes, and she remained his faithful wife until his decease, and has remained his widow since the death of her said husband. The personal description of the said C. B., her deceased husband, is as follows: Age, about years; height,

[blocks in formation]

1145. Guardian's Application, on Behalf of Minor Children, for Navy

Pensions.

[As in Form 1138 to the *, continuing thus:] makes the following declaration, as guardian of the minor child [or, children] of C. B., deceased, in order to obtain for him [or, them] the benefit of the act of Congress approved July 14, 1862: That he is the guardian of [naming the minor child or chil

Applications for Pensions.

dren, his ward or wards], child [or, children] of said deceased, who was in the United States navy, and on board the in the

[ocr errors]
[ocr errors]
[ocr errors]
[ocr errors]

commanded by [Continue as in Form 1140 from the † to the end.]

1146. Mother's Application for Navy Pension.

[As in Form 1138 to the *, continuing thus:] makes the following declaration, in order to obtain the benefit of the act of Congress approved July 14, 1862: That she is the widow of C. B., deceased, and mother of [naming sailor], who was a in the United States navy, on board the commanded by [Continue as in Form 1141 from the † to the end.]

1147. Guardian's Application on Behalf of Orphan Sisters.

[As in Form 1138 to the *, continuing thus:] makes the following declaration, as guardian of the orphan sister of C. B., deceased, in order to obtain for the benefit of the act of Congress approved July 14, 1862, granting pensions to orphan sisters, under sixteen years of age, of deceased officers and soldiers: That he is the legally-appointed guardian of [name the minor child or children, his ward or wards] who is [or, are] the only surviving daughter under sixteen years of age, of his wife, in the United

[ocr errors]

commanded by

and

of

[ocr errors]

who

[ocr errors]
[ocr errors]

18 [here state the

both deceased, and sister of [naming sailor], who was a States navy, on board of the died [or, was killed] in the service aforesaid, and in the line of duty, at in the State of on or about the day of cause of death]; that said C. B., brother of his said ward , upon whom she is wholly or in part dependent for support, having left no widow, minor children or mother, the claimant, as guardian and in behalf of said ward refers to the accompanying evidence, and to such as may be found in the department, to establish this claim. He further declares that [continue as in Form 1140 from the § to the end].

1

1148. Application for Prize-money.

STATE [etc., as in Form 1138].

I, A. B., do solemnly swear that I am the identical A. B. who served by that name as a

on board the United States

[merged small][ocr errors]
[ocr errors][merged small]
[merged small][ocr errors]

18 signed by

[ocr errors]

and surrendered. I also solemnly swear that
am a native of
; that I enlisted at

, 18, in the grade of

[merged small][ocr errors]

I am now years of age; on or about the ; that my ship's number was

day of

I

also solemnly swear that I have not made any previous assignment of or application for the prize-money now claimed by me; and further, that I now reside at

[ocr errors][merged small][merged small][merged small][ocr errors][merged small]
« ПредыдущаяПродолжить »