The act of June 27, 1890, requires that in minor children's cases who are permanently helpless1. That the soldier served at least ninety days in the war of the rebellion and was HONORABLY

DISCHARGED.

2. Proof of soldier's death [cause need not have been due to army service], his marriage to mother, and proof of her death or divestment of title.

3. In case a minor child is insane, idiotic, or otherwise permanently helpless, the pension shall continue during the life of said child, or during the period of such disability, and this proviso shall apply to all pensions heretofore granted or hereafter to be granted under this or any for mer statute, and such pensions shall commence from the date of application therefor after the passage of this act.

4. That the child of soldier was under the age of sixteen years at date of the death or remar

riage of widow.

[3-029.]

DECLARATION FOR NURSE'S PENSION.

[To be executed before some officer authorized to administer oaths for general purposes. The official character and signature of any such officer not required by law to use a seal must be certified by the clerk of the proper court, giving dates of beginning and close of official term.]

said,

County of day of

ss:

STATE OF On this A. D. one thousand eight hundred and ninetypersonally appeared before me, a within and for the county and State aforea resident of State of who, being duly sworn according to law, states that she was born in the year 18-, and is age. That she is the identical person who was employed by and that she served under the name of 186-, to the That her service was rendered in where she served at least

day of

years of as nurse,

from the day of 186-, when she was honorably released at [here state post, camp, or general hospital], months during the war of the rebellion. That she [here name causes for inability to

is unable to earn a support by reason of earn a support]. The said disabilities are to the best of her knowledge and belief

applied for

of a permanent character. That claimant has received a pension as [widow, mother, or nurse] under the general law or by special act of Congress, [If claimant's husband or sons have rendered service in the Army or Navy, that fact must be stated, with name of soldier in full, giving company and regiment. If they are pensioners or applicants for pension, the number of their claims must be stated.] That she makes this declaration for the purpose of having her name placed on the pension roll of the United States under the provisions of the act of August 5, 1892.

of

State of

She hereby requests that be allowed to act as her attorney to prosecute her claim, which service he agrees to render without compensation, under the penalty of the law. That her post-office address is No.

State of

street,

county of

[Signature of claimant in full.]

Attest:

residing at

and

Also personally appeared residing at [give street and number, if in city], 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 for years and years respectively, that she is the identical person she represents herself to be; and that they have no interest in the prosecution of this claim.

[If witnesses sign by mark, their signatures must be attested by persons

who write.]

(1)

(2)

[Signatures of witnesses.]

Sworn to and subscribed before me this

[L. S.]

hereby certify that the contents of the above declaration, etc., 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.

FILED BY

INSTRUCTIONS.

If the rolls of the hospital show employment for the period named, it can be ascertained by this office, and no other proof of this fact will be required.

If the Surgeon-General has no record of the service, other proof will be required as to the fact and period of service, which will be considered in the following order: Original documents; evidence of surgeons or assistant surgeons in charge of hospital; hospital stewards or enlisted men who were on duty with claimant and whose service is of record.

Claimant's inability to earn a support may be shown by the affidavit of her family physician, or by the evidence of two witnesses. The nature of the disability need not be named. If, however, claimant is sixty-five (65) years of age, and that fact is stated in her declaration, and she will furnish the evidence of one credible witness to corroborate her statement, the same can be accepted as sufficient to show inability to earn a support.

If claimant has married or remarried since her service, that fact should be shown.

ACT granting pensions to army nurses.

Be it enacted, &c., That all women employed by the Surgeon-General of the Army as nurses, under contract or otherwise, during the late War of the Rebellion, or who were employed as nurses during such period by authority which is recognized by the War Department, and who rendered actual service as nurses in attendance upon the sick or wounded in any regimental, post, camp, or general hospital of the armies of the United States for the period of six months or more, and who were honorably relieved from such service, and who are now or may hereafter be unable to earn a support, shall, upon making due proof of the fact according to such rules and regulations as the Secretary of the Interior may provide, be placed upon the list of pensioners of the United States and be entitled to receive a pension of twelve dollars per month, and such pension shall commence from the date of the filing of the application in the Pension Office after the passage of this act: Provided, That no person shall receive more than one pension for the same period.

SEC. 2. That no fee, compensation, or allowance, shall be paid to, received, or accepted by any agent, attorney, or other person instrumental in the prosecution of any claim for pension under this act; and any person who may make any claim upon any applicant for any fee, compensation, or allowance shall be guilty of a misdemeanor, and upon conviction shall be fined not exceeding five hundred dollars, or imprisonment at hard labor not exceeding one year, or both, in the discretion of the court; and it shall be the duty of the Interior and War Departments to render all proper aid to applicants under this act. [August 5, 1892.]

[Signature.]

[Official character.]

STATE OF
On this

[3-560.]

APPLICATION FOR ACCRUED PENSION (WIDOWS).

County of day of

SS:

189-, personally appeared duly sworn, declares that she is the lawful widow of

he died on the

certificate No.

who, being deceased; that

up to the - day

day of 18-; that he had been granted a pension by which is herewith returned (or if not, state why not) that he had been paid the pension by the pension agent at of 18-; after which date he had not been employed or paid in the Army, Navy, or Marine service of the United States, except ; that she was married to the said in the State -; that she had (or

of

on the

day of

18-, at

-; that her name before said marriage was had not) been previously married; that her husband had (or had not) been previously married; that she hereby makes application for the pension which had accrued on aforesaid certificate to the date of death; and that her residence is No. street, city of post-office address is

--, county of

State of

and her

Also personally appeared residing at

who, being duly sworn, say they were present and saw sign her name (make her mark) to the foregoing declaration; that they know her to be the lawful widow of who died on the — day of 18—; and that their means of knowledge that said parties were husband and wife, and that the husband died on said date, are as follows:

[Signature of witnesses.]

day of

Sworn to and subscribed before me on this 189-, and I certify that the affiants are reputable persons; that they know the contents of their depositions, and that their statements are entitled to full faith and credit. I further certify that I have no interest, direct or indirect, in the above claim.

court of the county aforesaid, do hereby cerduly commissioned and qualified; that his comday of 18-, and will expire on the

of ——, 189—, and that his signature within written is genuine.

Given under my hand and the seal of said court this

day

[3-560]

Evidence upon the following points should accompany the application for accrued pension: 1st. Proof of marriage.

2d. Proof that the widow and the pensioner had never been married before, or if they had been married to other persons, proof of the death of such person, or proof of divorce.

Proof of marriage should be made by copies of any public records of that fact if in existence; if this can not be had, then the sworn statement of the clergyman or magistrate who performed the ceremony, or of two persons who were present at the ceremony; if this proof can not be made, then the evidence of length of time parties lived together as husband and wife and the testimony of two or more neighbors who know the parties lived together as husband and wife, and the testimony of two or more neighbors who know the parties lived together and were recognized as husband and wife.

Proof should be made in the order named above, or satisfactory reason given why the best evidence can not be furnished.

This application

Pensions

should be properly executed and forwarded to the Commissioner of

It is desirable that the witnesses should be able to write their own names; if not, their marks should be witnessed.