The Portsmouth inquirer. [volume] (Portsmouth, O. [Ohio]) 1849-1855, 1850-11-04
FORM OF A DECLARATION TO BE MADE BY
THE SURVIVING OFFICER OR SOLDIER.

| FORM OF DECLARATION TO BE MADE By
THE SURVIVING OFFICER OR SOLDIER.
State of -, County of -, SIS.
On this - day of -, A. d. one thou.
sand eight hundred and =, personally ap.
pearod before me, Justice Of the Peace,
or other officer authorized to administer
oaths for general pmposcs.) within and
for the county and State aforesaid, -, aged
- years. resident of =, in the State Of
-, who being duly sworn according to law,
declares that he is the Identical - who
was - in the compOny* commanded by
Capt. - in the - regiment Of - COM
manded by - in the war with Great Brit.
ain, declared by the United States on the
18th day of June, 1912, Tor rather aodr
embraced in said act, describing trtat car J
that he enlisted, (or volunteered, or was
drafted, at -, on or about the = day Of
| -, A. d. -, for the term Of, and con-
tinued in actual service in said war for the
term Of -, and was honorably discharged
at -, on = day of -, A. d. -, as will
appear by his original certificate of dis.
charge herewith presented,t or by the mus
ter rolls of said company.
He makes this declaration for the pur.
pose of obtaining the bounty land TO which
he may be entitled under the "act grant
ing bounty land to certain officers and SOL
Giers who have been engaged in the mill.
tary service Of the United States" passed
September 26th, 1850.
signature of the claimant.)
Sworn to and subscribed before me the
day and year above written. And here
by certify that | believe the said - to be
the Identical man that served as aforesaid.
and that he is of the age above stated.
| signature of hemagstrate or other officer)
FORM OF A DECLARATION TO BE MADE by
THE WIDOW OF A DECEASED OFFICE OR
SOLDIER.
State Of, County of -. ss.
On this - day of -. A. d. one thou
sand eight hundred and -, personally op-
peared before me, q Justice of the Peace,
or other officer authorized to administer
oaths for general pmposes,) within and
for the county and State aforesaid. -,
aged - years, resident Of -, in the
State Of, who being duly sworn accord
ing to law, declares that she is the widow
of -, deceased, who was = in the com.
pany commanded by Capt, = in the -
regiment Of commanded by =, in the
war with Great Britain declared by the
United States on the 18th of June, 1912,
Tor other aoar as the case may Je3 that
her said husband enlisted, Tor polunteered,
or ras dratled) at -, on or about the -
day Of IA d. -, for the term of =, g.
continued in actual service in said war for
theterm Of, g. was honorably discharged
at -, on the - day Of -, A. d. -, as
,uiH appear By his original certificate Of
discharge hereioith presented.t ,s
She further states that she was mar
rried to tho said - in on the - day o.
-, A d.. -, by one - n =, and thnt hel
name before said maFriugo was -; tina,
lhor said husband died nt - on the - day
lof--, AID, M, and that she is still a wild
low. Il lass s.saal.. K. Z
She makes this declaration for tho pur.
lpose Of obtaining the bounty land 10 whicI
Ishe may be entitled under the "act passed
lSeptomber 2Sth 1850" li
Claimants signuture,)