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 judicia 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 the adjudication of claims, all the requisite evidence that is available should be forwarded with the application. FILED BY County of day of ss: H On this 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, in the State of a resident of county 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 granting pensions to dependent mothers: That she is the1 under the name of in 3 in the war of that said son band, the aforesaid who 2 A. D. 18-, A. D. 18-; left neither widow nor child under sixteen years of age surdependent upon said son for support; that her hus; that there were viving; that she was 5 surviving, at date of said son's death, his brothers and sisters, who were under sixteen years of age, as follows: she has not aided or abetted the rebellion; that she hereby appoints ; that -in and that in -- and sons 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. [Signatures of witnesses.] 1"Wife" or "widow." 2 "Enlisted, 99.66 was drafted," etc. State company and regiment, if in the Army; and vessel, etc., if in the Navy. 4 State nature of wounds and all circumstances attending them, or the disease and manner in which it was incurred, in either case showing soldier's death to have been the sequence; also service and rank at time of death. 5" Wholly" or "in part." "If husband is dead, so state, giving date of death; also whether applicant has remarried. If still living, his inability to support applicant should be accounted for. "If either she or the soldier has previously applied, so state, giving number of claim. 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 the adjudication of claims, all the requisite evidence that is available should be forwarded with the application. Regt. Sworn to and subscribed before me this day of —, A. D. 18—, 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. [Signature.] [Official character.] FILED BY [3-018.] DECLARATION FOR ORIGINAL PENSION OF A FATHER. STATE OF County of day of On this 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, aged years, who, being duly sworn according to law, makes the following declaration in order to obtain the pension provided by acts of Congress granting pensions to dependent fathers: That he is the father of under the name of A. D. 18-, in1 — in the war A. D. 18-, who bore at the time ; that said son, left neither of at who 2 of his death the rank of on the on the day of day of in 3 who widow nor child under sixteen years of age surviving; that the declarant was married to the mother of said son at A. D. —, dependent upon said son for support; that the mother of said son died at A. D. —; that there were surviving, at date of said son's death, his brothers and sisters who were under sixteen years of age, as follows: he has not aided or abetted the rebellion; that he hereby appoints and that [Claimant's signature.] and residing at No. 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 his name (make his mark) to the foregoing declaration; that they have every reason to believe, from the appearance of said claimant and their acquaintance with him, that he is the identical person he represents himself to be; and that they have no interest in the prosecution of this claim. [Signatures of witnesses.] 1 State company and regiment, if in the Army; and vessel, &c., if in the Navy. 2 State nature of wounds and all circumstances attending them, or the disease and manner in which it was incurred; in either case showing soldier's death to have been the sequence. 3 State company or regiment, if in the Army; and vessel, &c., if in the Navy. 4 "Wholly," or "in part." 5 If either he, the mother, or the soldier has previously applied, so state, giving the number of the claim. 6661-13 day of Sworn to and subscribed before me this 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. 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. ney, The post-office address (naming street and number in all large cities) of the applicant, attorand 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 the adjudication of claims, all the requisite evidence that is available should be forwarded with the application. Furnishing this blank as requested does not indicate that there is a valid claim to pension. That fact can be ascertained only after all the necessary evidence has been filed. It must appear that the soldier died of injury received or disability contracted while in the military or naval service. [Signature.] [Official character.] |