Lapas attēli
PDF
ePub

E

[3-014.]

E

DECLARATION OF A PENSIONED WIDOW FOR INCREASE OF PENSION.

STATE OF
On this

[ocr errors]

County of day of

SS:

A. D. one thousand eight hundred and ninetypersonally appeared before me the same being a court of

record within and for the county and State aforesaid,

[ocr errors]

county of

[ocr errors]

in the State of

[ocr errors]

who was a1

in

[ocr errors][merged small]

-; that on dollars per month,

of aged years, who, being duly sworn according to law, makes the following declaration in order to obtain the pension provided by acts of Congress increasing the pensions of widows: That she is the widow of in the war of account of his death she has been granted a pension of in accordance with a certificate numbered is herewith returned; that she has not remarried since the death of her husband above named; that the following are the names and dates of births of all his legitimate children yet surviving, and were under sixteen years of age at the father's death, to wit:

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

That she has not abandoned the support of any one of his children, but that they are still under her care or maintenance?

her attorney to prosecute her claim; that her residence is at No.

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

in and -residing at No. —, in whom I certify to be respectable and entitled to credit, and who, being by me duly sworn, say that they were present and saw the claimant, sign her name (make her mark) to the foregoing declaration; that they have every reason to believe, from the appearance of said claimant 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 and subscribed before me this

[Signatures of witnesses.]

day of, A. D. 189—, and I hereby certify that the contents of the above declaration, &c., were fully [L. S.] made known and explained to the applicant and witnesses before swearing, including the words

erased, and the words

added; and that I have no interest, direct or indirect, in the prosecution of this claim.

[Signature.]

[Official character.]

1 State company and regiment, if in Army; or vessel and rank, if in Navy.

2 For such children as are not under her care claimant should account.

[blocks in formation]

All the blanks in this form should be carefully filled and the requirements of the notes strictly observed.

An honorable discharge from the service in all cases is necessary.

Declarations of claimants, either for original pension or for increase of pension already granted, must be made before a court of record, or before some officer thereof having custody of its seal, said officer being fully authorized and empowered to administer and certify any oath or affirmation relating to any pension or application therefor.

The claimant's identity and loyalty must be proven by two witnesses, certified by the judicial officer to be respectable and credible, who are present and witness the signature of the declarant, and certify to his identity and loyalty under oath or affirmation.

Declarations and other papers should be as legible and as clear in statement as possible. Where any evidence is already on file in any Department of the Government, a definite description of and specific reference to it will render it available in any subsequent claim. The post-office address (naming street and number in all large cities) of the applicant, attorney, and witnesses should be embodied in or accompany every application, and all evidence in each claim; and each change of residence of said parties, while communicating with the Pension Office or the pension agents, should be stated.

Pensions are, by law, exempted from any liability on account of the obligations of the pensioners, and no lien upon them can be recognized.

All facts, testimony of which is required to establish a claim, must be proven by the affidavits of two or more credible witnesses, unless other evidence is specified.

The statements of claimants, unless duly corroborated, are not accepted as evidence.

Testimony, in support of allegations made in a declaration, may be taken before any officer whose authority and signature are duly certified, and who shall disclaim any interest, direct or indirect, in the prosecution of the claim.

Persons desiring to complete claims pending at the decease of the claimants must furnish a duly verified certificate of their authority as heirs or legal representatives.

With all claims for arrears, increase, or restoration to the rolls, the original pension certificate must be returned, or explanation of its absence must be given under oath.

To facilitate adjudication of claims, all the requisite evidence that is available should be forwarded with the application.

Vols.

FILED BY

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

STATE OF
On this
personally appeared before me, a
county and State aforesaid,
the State of

a resident of

-, county of. —, in aged years, who, being duly sworn according to law, makes the following declaration in order to obtain the pension provided by acts of Congress for children under sixteen years of age: That is the only legal guardian

under the name

of

[ocr errors]

legitimate children of

who 1

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

the following named are the only surviving legitimate children of said who were under sixteen years of age at the time of his death:

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

there being no legal barrier to such marriage; that the said children have not aided

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

whom I certify to be respectable and entitled to credit, and who, being by me duly sworn, say that they were present and saw the claimant, sign

name (make

[ocr errors]

mark) to the foregoing declaration; that they have every reason

1" Was enlisted," 'drafted," or otherwise, as the case may be.

2 State company and regiment, if in Army; or vessel, etc., if in Navy..

3 If soldier died in service, so state. If he died after his discharge from service, state cause of death and when and where he contracted the fatal disease or incurred the wound or injury that resulted in his death.

4 If widow survived, so state, giving her name and the date of her death or other facts divesting her title.

5State names of children and of their mothers, and dates of birth.

"If more than once married, so state, giving names and dates and parties officiating.

"If either soldier, widow, or guardian of children have previously applied, so state, giving date and number of application.

[blocks in formation]

to believe, from the appearance of said claimant and their acquaintance with that is the identical person·

represents

interest in the prosecution of this claim.

to be; and that they have no

Sworn to and subscribed before me this

[Signatures of witnesses.]

day of

-—, A. D. 189—, and I hereby certify that the contents of the above declaration, etc., were fully

[L. S.] made known and explained to the applicant and witnesses before swearing, including the words erased and the words

added; and

that I have no interest, direct or indirect, in the prosecution of this claim.

All the blanks in this form should be carefully filled and the requirements of the notes strictly observed.

A discharge from the service in all cases is necessary.

The claimant's identity must be proven by two witnesses, who are present and witness the signature of the declarant, and certify to his identity under oath or affirmation.

Declarations and other papers should be as legible and as clear in statement as possible. Where any evidence is already on file in any department of the Government, a definite description of and specific reference to it will render it available in any subsequent claim.

The post-office address (naming street and number in all large cities) of the applicant, attor ney, and witnesses should be embodied in or accompany every application and all evidence in each claim, and each change of residence of said parties while communicating with the Pension Office or the pension agents should be stated.

Pensions are by law exempted from any liability on account of the obligations of the rensioners, and no lien upon them can be recognized.

All facts, testimony of which is required to establish a claim, must be proven by the affidavits of two or more credible witnesses, unless other evidence is specified.

The statements of claimants, unless duly corroborated, are not accepted as evidence. Declarations and testimony in support of allegations made in a declaration may be taken before any officer whose authority and signature are duly certified and who shall disclaim any interest, direct or indirect, in the prosecution of the claim.

Persons desiring to complete claims pending at the decease of the claimants must furnish a duly verified certificate of their authority as heirs or legal representatives.

With all claims for arrears, increase, or restoration to the rolls, the original pension certificate must be returned or explanation of its absence must be given under oath.

To facilitate the adjudication of claims, all the requisite evidence that is available should be forwarded with the application.

[blocks in formation]

[3-016.]

DECLARATION OF GUARDIAN FOR INCREASE OF PENSION TO PENSIONED CHILDREN.

[ocr errors]

County of day of

ss:

[ocr errors]
[ocr errors]

record within and for the county and State aforesaid,

G

[ocr errors]

STATE OF On this A. D. one thousand eight hundred and ninetypersonally appeared before me, the same being a court of a resident of -, county of aged years, who, being duly sworn according to law, makes the following declaration in order to obtain the benefit of the provisions of acts of Congress increasing the pensions of orphans: That - is the only legal guardian of -, legitimate children of who was 1

in the State of

-; that on account of his death they have been granted pen

bearing date

[ocr errors]

sion in accordance with the certificate numbered and which is herewith returned; and that the name and dates of birth of all his legitimate children yet surviving, who were under sixteen years at the date of the father's death, are as follows:

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

That

hereby appoints

claim; that h-residence is at No.

in

born

h- attorney to prosecute the above street, in the

county of ▬▬▬, State of▬▬▬, and that h— post-office address is

of

[Claimant's signature.]

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

residing at No.

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

whom I certify to be respectable and entitled to credit, and who, being by me duly sworn, say that they were present and saw the claimant, sign h— mark) to the foregoing declaration; that they have every reason to believe, from the appearance of said claimant and their acquaintance with that is the identical person represents-self to be; and that they have

no interest in the prosecution of this claim.

[blocks in formation]

Sworn to and subscribed before me this hereby certify that the contents of the above declaration, &c., were fully [L.S.] made known and explained to the applicant and witnesses before swearing, including the words —, erased, and the words - added; and that I have no interest, direct or indirect, in the prosecution of this claim.

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

1 State rank, company, and regiment, if in Army; or rank, vessel, &c., if in Navy.

2 State names of children and of their mothers, and dates of birth.

« iepriekšējāTurpināt »