The daily republic. [volume] (Washington, D.C.) 1853-1853, 1853-07-28
day of ,l8 by regular
o nf discharDe Aligned hv .ll-af8 that

the :, day d. Of ., l g. by regular ,hst
/ am unable to produce said discharge by reason
of here state the reason in full If lost giUs the pro-
babie fine and MANNER Of The loss; If sold or trans
fevrd STATE to sphom and for schat puvpose giuing
Government, gius the name Of he Office. he time uhen
specify il; If no scritisn discharge receiUed,
state the fact and the reason.]
and am employed as H&
f (To be signed by claimant.)
Sworn to and subscribed before me this
day of "A. d. l8 And certify that
to my knowledge the statement of deponent in
gard to bis residence and employment 10 true; my
knowledge of deponent being derived from there
the magistrate soiH state ,nefher from personal
q,laintamcs, or othsr,oise AndI also certify that
the above named deponent appears to be about the
age stated by him; that he is about feet
inches in height; of complex
Ito be signed by authenticating ofIicer.)
There should follow receipt and acknowledge
ment of receipt, as in formI.
CERTIFICATE OF IDENTITY FROM A COMMISSIONED
a. Oh WARRANT OFFICER OF THE NAVY,
(Which soiH be required in cases sphere the dis
charge is lost or mislaid)
i
ing receipt in duplicate in my presence, is the
identical who served on board the United
States ship which served in the Pacific
ocean on the coast of California and Mexico, in the
The he said ship on or about
10 that the person of the said is well
known and fully identified by me as the present
claimant for extra pay.
Ito be signed by commissioned or warrant Of
fcer of the navy, suboining his rank.)
Where the discharge has been filed in any Office
of the Government, copy thereof certified by the
head of such Office, must be furnished, and claim
ant will make oath, in addition to the matter re-
qured in the last form for affidavit of claimant,
that he is unable to procure such certificate from
commissioned or warrant officer of the navy
and then the evidence of two witnesses may be re-
ceived as provided for when the discharge is pre-
gard to the discharge.
@ III. !.
Form Of certificate from commissioned or
,oarrant officer required for an enlisted per-
SON on board a vesseL of the United States al
the date of his application for eutra pay.
lin this case the oath of identity may be omit
certify that the following receipt in duplicate
was signed in my presence by \, whose
person is we'll known to me; and the said
did aifix to the original thereof his discharge
te from the United States chip
and know him to be the identical person named
said discharge and further asts certify that the
on board of this vessel:
Dated on board the United States ship ),
this day of 1856
ITO be signed by the officer, subjoning his
Here should follow the receipt of claimant as in
form J.. @ a Ht
Where a person as above has no discharge in
possession, the certifying officer will make his
ifcaie as,s prescribed for officers in form II, for
such purpose, adding thereto the claimants repre-
sentaton to his failure to have said certificate
of discharge in his possession.
".
When the extra pay is due to person deceased,
it will be paid to his legal representative, made
euch by letters testamenary or of adminst ration.
Such letters, duly granted, or copies thereof duly
au hentcated by the clerk proper officer OF the
probate court, or other court having jurisdiction
in the case, and which granted the original letters
will be required with the duplicate receipts, the
certificate of the magistrate, in other casee and
the following oath of identity Haa
Form Of Oath Of Identify BY Administrator, &c.
/, of in the county of
State of depose and say
that am the identical named in the ac-
companying letters of administration. Cor letters
testamentary, on copy of letters, &C., the case
may be,) on the estate OF deceased, and
that said letters are unrevoked, and now in full
force and effect; that the said wac at the
time of his death legal resident of ,,
he was the identical person who served by that
name on board the United States ship
on the coast of California in the years
and who died Estate ,chere he died. and tchether he
tcas in the seruice f the United STATES or not at the
time of his DEATH on or about the day OF
@ IS and to whose estate extra pay is
due under the provisions of the act of Congress OF
March 3, 1853, and for which extra pay now ap-
ply as his legal representative.
: olsssa (Administraior or Brecutor)
STATE OF }ss
County Of
Personally appeared before me in
and for the State and county aforesaid duly quail
fed to administer oaths, who signed the
foregoing deposition in my presence, and made
oath to the truth of the same.
And certify that know the said deponent to be
the administrator named in the accompanying let
tiers of administration.
Witness my hand this day OF D
A. d. 1875
Justice of The Peace or other Magistraie)
Ifan executor or administrator desires to be paid
througha third party, he will execute power OF
attorney and acknowledgement OF the same accord
ing to the forms (V) hereafter prescribed, max
ing the necessary changes.
If the decedent was discharged previous to his
death, his discharge, if left with his effects must
be filed, and the administrator or executor must
add to his deposition, "and further depose that
the said ,on whose account Iciaim extra
paw was the identical named in the Ger
iificate of discharge dated lis and
signed by which is herewith surren-
dered." ..-.-
If the certificate Of discharge cannot be found,
the administrator or executor will state the fact in
his deposition, and that due search and inquiry
have been made for it among the effects Of the de-
cedent. If the administrators or executor have any