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personally appeared before me

ord within and for the county and State aforesaid,

in the state of

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aged

the same being a court of rec-
a resident of
9

years, who, being duly sworn

county of according to law, makes the following declaration in order to obtain the pension provided by acts of Congress for dependent brothers and sisters: That

only legal guardian of

brothers and sisters

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who died 3

on the
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day of

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the name of

in the war of

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day of 18-, and who bore at the time of his death the rank of in 4 ; that he left neither widow, minor child, nor -; that the above named are the only legitimate brothers and sisters, including those of the half-blood, of the said deceased surviving, who were under sixteen years of age at the time ; that said brothers

of his death and were dependent upon him, of whom 6. and sisters were the issue of the parents of said soldier, as follows, the dates of their births being as herein stated:"

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That the parents were married under the names of 8

there being no legal barrier to such marriage; that none of said brothers or sisters have aided or abetted the rebellion; that prior application has been filed;" h-attorney to prosecute the above street, in the and that h― post-office address is

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and 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— name (make mark) to the foregoing declaration; that they have every reason to believe, from the appearance of said claimant and their acquaintance with

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

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

3 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. 4"In the service aforesaid," or otherwise, as may have been the case.

5 If mother or father survived the soldier and subsequently died, so state, giving date of death; otherwise add "mother nor father surviving."

If any have died state date of death.

"State names of children and of both parents, also date of birth.

8 Give names of parents and places and dates of marriages.

"If either soldier or his father or mother have previously applied, so state, giving date and number of application.

that

is the identical person

represents self to be; and that they have

no interest in the prosecution of this claim.

Sworn to and subscribed before me this day of - A. D. 189-, and I hereby certify that the contents of the above declaration, &c., were fully 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.

[L. S.]

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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.

[Signatures of witnesses.]

U.

[3-026.]

U.

WAR OF 1812.-DECLARATION OF A WIDOW FOR PENSION UNDER ACT OF FEBRUARY 14, 1871.

SS:

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STATE OF
County of
On this
- day of
A. D. one thousand eight hundred and ninety-
personally appeared before me

within and for the county and State aforesaid,
resident of

-, county of

ing to law, declares that she is period of sixty days in the 1

State of

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the widow of

of the

a court of record aged

years, a

who, being duly sworn accord

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who served the full service of the United States in the war of 1812; who 2 in Captain division, at

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181-, and was honorably discharged at

day of there being no legal barrier to said marriage; that her said on the day of — 18-, and that she has not remar

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ried since his death; that at no time during the late rebellion against the authority of the United States did she or her said husband adhere to the cause of the enemies of the Government, giving them aid or comfort, or exercise the functions of any office whatever under any authority, or pretended authority, in hostility to the United States; that she will support the Constitution of the United States; that she is not in receipt of a pension under any previous act; that she makes this declaration for the purpose of being placed on the pension roll of the United States under the provisions of the act approved February 14, 1871, and hereby constitutes and appoints, with full power of substitution and revocation of her true and lawful attorney to prosecute her claim and procure the issuance of a pension certificate to her. That her post-office address is

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at -, persons whom I certify to be respectable and entitled to credit, and who, being by me duly sworn, say they were present and saw the claimant, sign her name (or 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 at no time during the late rebellion against the authority of the United States did she, or her said husband, adhere to the cause of the enemies of the Government, or give them aid or comfort; and that they have no interest in the prosecution of this claim.

[Signatures of witnesses.]

1 "Military" or "naval."

2" Was drafted," "enlisted," or "was enrolled."

Here give place, capacity, and manner of service, and any historical events in the war in which he participated, or with which he was connected.

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Sworn to and subscribed before me this

day of

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

cluding the words

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added; and that I

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

By an act of Congress approved February 14, 1871, pensions at the rate of $8 per month are granted to the officers and enlisted and drafted men (both militia and volunteers) of the military and naval service of the United States in the war of 1812 who served for a period of sixty days, and to the widows of those who have died who were married prior to the treaty of peace (February 17, 1815) which terminated said war. Also to such officers and soldiers who served less than sixty days who have been personally named in any resolution of Congress for any specific service in said war.

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

Declarations of these claimants 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 loy

Under this act three classes of claims will alty under oath or affirmation. arise:

First.-Of officers, soldiers, and sailors, who served for sixty days, who have never been pensioned for a disability incurred in the service of the United States. These will be entitled to a full pension of $8 per month from February 14, 1871. Second. Of officers, soldiers, and sailors, who served for sixty days, but who are in receipt of a pension for disability incurred in the service of the United States. These will be entitied to an increase of their pension to $8 per month from February 14, 1871.

Third. Of widows of officers, soldiers, and sailors who served sixty days who were married to the soldier prior to the treaty of peace which terminated said war (February 17, 1815), and who have since remarried. These will not be entitled to $8 per month from February 14, 1871.

If the term of service was less than sixty days, there is no claim for pension under this act, unless the person who served has been personally mentioned in a resolution of Congress for some specific service in said war; in which case he or his widow is entitled to the same benefits under its provisions as though he had served the full period of sixty days.

The declaration must recite the name, age, and residence of claimant; whether married or unmarried; that the term of service was the full period of sixty days; or that he has been mentioned in a resolution of Congress, giving date of resolution; the place and time of enlistment and discharge, and the company, regiment, brigade, and division in which he served; the places, capacity, and manner of service, and his participation in, or connection with, any historical event of the war are particularly desired to be mentioned.

The declaration must also contain the following oath:

"That I (if a widow, "That neither I nor my said husband") at no time during the late rebellion against the authority of the United States, adhered to the cause of the enemies of the Government, giving them aid or comfort, or exercised the functions of any office, under any authority, or pretended authority, in hostility to the United States, and that I will support the Constitution of the United States."

[Signature of magistrate.]

[Official character.]

FILED BY

[3-028.]

WAR OF 1812.

CLAIM OF WIDOW FOR SERVICE PENSION UNDER THE PROVISIONS OF SECTIONS 4736 TO 4740 (INCLUSIVE), REVISED STATUTES, AND THE ACT OF MARCH 9TH, 1878.

[N. B.-All the blank spaces in this form must be carefully filled up in accordance with the instructions on the back hereof, and from the best information possessed, or obtainable, by the applicant.]

STATE OF

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ss:

County of On this day of A. D. one thousand eight hundred and -, personally appeared before me, the same being a court of record within aged - years, a resident of who, being duly sworn according to law, declares deceased, who was the identical (3)

and for the county and State aforesaid, (1) in the State of

that she is the widow of (2)

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who served under the name of (4) pany commanded by Captain manded by

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in the war of 1812; that her said husband (6)
day of
A. D.

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on or about the continued in actual service in said war for the term of (7)

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—, A. D.

She further states that the following is a full description of her said husband
She further states that she was mar-

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died at A. D. and that she has not again married; and she further declares that the following have been the places of residence of herself and her said husband since the date of his discharge from the Army, viz: (14) ·

She makes this declaration for the purpose of obtaining the pension to which she may be entitled under sections 4736 to 4740 (inclusive), Revised Statutes, and the act of March 9th, 1878, and hereby appoints of —, her true and lawful attorney to prosecute her claim; and she further declares that she has heretofore made application for (15) and that her residence is No. street, city (or town) of

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-, persons whom I certify to be respectable and entitled to credit, and who, being by me duly sworn, say that they have known the said for years, respectively; that they were present and saw her sign her name (or 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 they further say that they are able to identify her as the person who was

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