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CLAIM OF WIDOW FOR SERVICE PENSION UNDER ACT OF JULY 27,
[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.
A full and explicit reply is required to all questions indicated by this blank.] STATE OF
County of On this day of
-, A. D.one thousand eight hundred and ninety-personally appeared before me, a within and for the county and State aforesaid, aged years, a resident of
in the State of who, being duly sworn according to law, declares that she is the widow of deceased, who was the identical person who served under the name of as a in the company commanded by Capt.
- Regiment of [if in the Navy, name vessels), commanded by in the war; that her said husband enlisted at on or about the day of A. D. 18—, for the term of -, and was discharged at the day of A. D. 18—; that he also served in Capt.
Co. Regt. Vols., from
18—; and in Capt.
18–, to 18—; that he was not otherwise employed in the military or naval service of the United States.
That at the time of entering the service claimed for, her said husband was years of age, - feet inches in height, with eyes, hair, complexion, by occupation a and that he was born at
, county of State of That after leaving the service he resided at
years, at years, and at That she was married to him on the day of A. D. 18—, at by under the name of
-; that he had (or had not) been previously married to
18% That her said husband died at
A. D. 18—; that she has (or has not) since remarried, to wit, to
day of A. D. 18— That she has heretofore made application for pension; that the number of her claim is ; that she has made application for bounty land, the number of her land warrant being -; that her husband did
make application for pension, the number of his claim being —; that he did make application for bounty land, the number of his warrant being
That she is a citizen of the United States, and makes this application for the purpose of obtaining a pension under the provisions of the act approved July 27, 1892; and hereby appoints
her true and lawful attorney. That her post-office address is No.
street, (city or town of) county of State of
[Signature of claimant in full.]
Also personally appeared
years, residing at No. street, in
years, residing at No. street, in -, 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, and do believe from the appearance of said claimant and from their personal acquaintance with her, that she is the identical person she represents her to be; and they further say that they are fully satisfied that she is the person who was the wife of the identical
· who rendered the service alleged in the above application in the company of Capt.
in the regiment of in the war), by the following-named facts and circumstances: -; and that they have no interest in the prosecution of this claim.
[Signatures of witnesses.]
[If witnesses sign by mark, their signatures must be attested by persons who write.]
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 read and explained to the applicant' and witnesses before swearing, including the words
added, and the words —, erased; and that I have no interest, direct or indirect, in the prosecution of this claim.
AN ACT granting pensions to the survivors of the Indian wars of eighteen hundred and thirty
two to eighteen hundred and forty-two, inclusive, known as the Black Hawk War, Creek War, Cherokee disturbances, and the Seminole War.
Be it enacted by the Senate and House of Representatives of the United States in Congress assembled, That the Secretary of the Interior be, and he is hereby, authorized and directed to place on the pension roll the names of the surviving officers and enlisted men, including marines, militia, and volunteers of the military and naval service of the United States, who served for thirty days in the Black Hawk War, the Creek War, the Cherokee disturbances, or the Florida War with the Seminole Indians, embracing a period from eighteen hundred and thirty-two to eighteen hundred and forty-two, inclusive, and were honorably discharged, and such other offcers, soldiers, and sailors as may have been personally named in any resolution of Congress, for any specific service in said Indian wars, although their term of service may have been less than thirty days, and the surviving widows of such officers and enlisted men: Provided, That such widows have not remarried: Provided further, That this act shall not apply to any person not a citizen of the United States.
SEC. 2. That pensions under this act shall be at the rate of eight dollars per month, and payable from and after the passage of this act, for and during the natural lives of the persons entitled thereto.
SEC. 3. That before the name of any person shall be placed on the pension roll under this act proof shall be made, under such rules and regulations as the Secretary of the Interior may prescribe, of the right of the applicant to a pension; and any person who shall falsely and corruptly take any oath required under this act shall be deemed guilty of perjury; and the Secretary of the Interior shall cause to be stricken from the pension roll the name of any person whenever it shall be made to appear by proof satisfactory to him that such name was put upon such roll through false and fraudulent representations, and that such person is not entitled to a pension under this act. The loss of the certificate of discharge shall not deprive any person of the benefits of this act, but other evidence of service performed and of an honorable discharge may be deemed sufficient.
SEC. 4. That this act shall not apply to any person who is receiving a pension at the rate of eight dollars per month or more, nor to any person receiving a pension of less than eight dollars per month, except for the difference between the pension now received (if less than eight dollars per month) and eight dollars per month.
SEC. 5. That the pension laws now in force, which are not inconsistent or in conflict with this act are hereby made a part of this act, so far as they may be applicable thereto.
SEC. 6. That section forty-seven hundred and sixteen of the Revised Statutes is hereby repealed, so far as the same relates to this act or to pensioners under this act.
Approved July 27, 1892.
[Act of June 27, 1890.) DECLARATION FOR INVALID PENSION.
, on the
STATE OF County of
On this day of , A. D. one thousand eight hundred and ninetypersonally appeared before me, a - within and for the county and State aforesaid,
years, a resident of
-, county of
-, State of who, being duly sworn according to law, declares that he is the identical person who was enrolled at under the name of
on the day of 18–, as a in [here state rank and company and regiment in the Army, or vessel, if in the Navy) in the service of the United States, in the war of the rebellion, and served at least ninety days, and was honorably discharged at
18%. That he also served [here give a complete statement of all other services if any). That he was not employed in the military or naval service prior to 18–. That he has not been employed in the military or naval service since 18–. That his personal description at enlistment was as follows: Age, years; height,
feet inches; complexion, ; hair, ; eyes,
That he is [wholly or in part] incapacitated for earning a support by manual labor by reason of [here name the disease or injuries by which disabled). That said disabilit- not due to his vicious habits, and to the best of his knowledge and belief of a permanent character. That he is a pensioner. That he has heretofore applied for pension. [If a pensioner, the certificate number only need be given. If not, give the number of the former application if one was made.] That he makes this declaration for the purpose of being placed on the pension roll of the United States under the provisions of the act of June 27, 1890. That he hereby appoints
of his true and lawful attorney to prosecute his claim. That his post-office address is county of State of
[Claimant's signature.] Attest:
(2) Also personally appeared
and residing 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 his name (or 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 of
years, respectively, that he is the identical person he represents himself to be; and that they have no interest in the prosecution of this claim.
- years and
[Signatures of witnesses.] Sworn to and subscribed before me this
day of -, A. D. 189—, and I hereby certify that the contents of the above declaration, etc., were fully
made known and explained to the applicant and witnesses before swearing, [L. s.] including the words erased, and the words -, added; and that
I have no interest, direct or indirect, in the prosecution of this claim.
To be executed before some officer of a court of record having custody of its seal, a notary public, justice of the peace, or other officer authorized to administer oaths for general purposes If such officer is not required by law to have and use a seal, his official character, signature, and term of office must be certified by the proper State, county, or city officer under his official seal, unless such a certificate has been filed in the Bureau of Pensions for general reference.
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.