Richmond enquirer. [volume] (Richmond, Va.) 1815-1867, 1820-05-26
lt The Palace, uareh &c, 1920.
MAR nEpAprMnNr

PENSION OFFICE. May nth, 1870.
In all original applications hereafter to be made
the purpose oil obtaining pensions, under the act Of
Congress providing fer certain persons who served In
tue land aud naval service of the United States during
aud tue act supplementary thereto passed ON tue Isl
May, 1870. the following form must be observed:
District u - IS.
ed in open court being court of iecordt for The dis
trict, circuit, county or corporation as the may
bel -, aged - years, who. heiny fret duly
sworn according Law, doth. on his OATH make the
following declaration, in order obtain the provision
made BY the acts OF Congress az the lsth March ISIS
aud the LIST May. 1870; that he the said - enlisted
for the tenn OF - on the - day Of - In
the yeas -, in the state Of -, IN the company
commanded by captaiu -. in The regimen, com.
msnded by colonel -, in the line OF the state Of
-. on the - continental establishment that
he continued To serve In the said corps until -,
when he was discharged from the said service in
-, in the state OF -. ri the declaiant shall
should forth the company regiment and line or
shir, vessel or corps in winch he may have served
as asothe Tune Of entering, and the time aud
of leaving each Bervce.i
That he mas i'll the hattie of -, and that he has
NO Other evidences now in his power Of his said ser
And in pursuance Of the act Of the LIST May, 1890
90 solemnly swear or affirm, (as the may bs) that
was resident citizen OF the United States, on the
ielh day of March, one tEousand eight hundred and
eShteehs and that have not, since that time, by gilt
sale, or in any manner disposed of nv ptsp,rty AZ,
any part thereof with intent thereby so TO diminish n
as 10 bring myself within the PROVISIONS OF act OF
SeneteSs. 'niititd, An act To provide for certain
persons engaged IN the land and naval service of
United States. IN The revolutionary passed on he
ISL. day of March. one thousand eight hundred and
e'ghteen aud that have not, has any person in
trust Tor me, any property securities contracts or
debt due TO ME nor have any Income ether ti,an
"hat Is contained IN tie schedule hereto annexed aud
by me subscribed.
There cnunerate zach artic,e Of real and persona,
estate necessary Clothing and bedding excepted and
s1bsciise The same. The declaIahl mnst also men
ton his occupation, his ability pursue it, the nun
ner and names of his family residing with him. their
ages ana their capacity 10 contribute their suppnrt
IN order thar The Department may be enabled 10 decide
whether the appeantis in such INDECENT circulDstan
cesi rs To be entitled 10 The pen.on.)
Sworn 10 and declared on the
- Gay of---, before -
r.. CLERK Of -, do hereby certify tina, the
foregoing oaih Cor aihrmaton.) and the schedule
theeto annexed, truly copied from the reco,a Dis OF
iae SAID court and do further certify that tits The
ophiob OF The said Court. that the total amount In
value OF The property exhibited in the af.rea aid scbe
ane, Is - dollars and - cents, in testimony
whereof, have hSreuuto set my hand, aud affixed
,he seal OF The said Court, ON this - day -.
Cleh of the Court Of Tire Of
Ia nil cases where the applicant Is on the pension
ru or declarations have been made In conformity to
ihe act of the 18th March, sIs, and the regulations OF
tht war department, prior To the LIST May 1870, the
.nOIoned blank form is prescribed for such person,
as may consider themselves entitled pen sions under
ne restrictions Of the act oftbe ,st OF May 1870
District of--.ss.
ON this - day OF -, 1872 personally appear
cd in open court. being court OF record Tor The
said district, tclrcn, county corporation, as the
case may he -, aged - years, resident in
-, in said district, tcircuit, county. or corpora
~
sotb. on his OATH declare that he in the ls,o
luuOhary war as pews here set forth the regiment
company, anc line, or ship, corps vessel aud the
uete OF tue original sesiaTaion and IL he has Teceiv.
ed pension, the number of the pension certificate
SHOULD be Inserted. And do solemnly swear Tor az
hIin, as the case NAV be that resident citizen
OF the u S. on the 18th day of Ma oh, 1913 and that
nave not since that time, by git, sale, any man.
hef, disposed OF my property, any part there
Win inient thereby To Diminish II, bring my
sell within the provisions Of act of Congress- emit
TIED " An act to provide for certain persons engaged
~ the land and naval service of The United states in
the revolutionary war;" passed on the 18th day OF
MARCH, 1873; aud That bave not, nor has any person
III tust for me- any property securities contracts
or debts, due tn have any income other than
what is contained In tue schedule hereto and
by me subscribed.
Here enumerate each article OF real aud personal
estate, necessary clothing aud bedding excepted and
subscribe the tame
The deciarsut must, also. mention his orcunation
BIS ability 10 pursue the nunher aud names of his
family residing With him their AGES and their cana
CITY 10 contribute TO their support in order that the
department may he enabled decide whether The an
ptcant is IN such INDECENT circustances as 10 be en-
titled TO the pension.
Sworn to and declared - on the day Of -
before
I, - clerk of - do hereby certify that thc fore,
going oath Tor anImaion) and the schesule thereto
annexed are truly copied from the record Of The said
court; and further certify, that IL is the opuiou OF
tue said court that the total III value Of the
property exhibited in the aforesaid schedule is -
dollars and - Gents. Ia testimony whereof have
heTeuno set my baud, aud affixed The seal of the said
court on this- day OF - 1872
Clerk Of The Court for The - Of =,