Daily evening star. [volume] (Washington [D.C.]) 1852-1854, 1854-03-15
TO be signed by claimant
To be signed by authenticating officer.

To be signed by authenticating officer.
Form Of receipt of claimant
=, navy agent at Washington, D. g, the he sum
OF - dollare and - ceDt', in full for
ship -, in the Pacific on the coast of Mexico
and California, in the years -, for which ser
vices extra pay is granted by the act of Congress en-
titled An act making appropriations for the naval
service for the year ending June 80, 1856 p
ITO be signed in duplicate by claimant
Form Of acknowledgment ofrccetR.
s' a5Ss 81 Of o. IS.
On this - day Of -, A. D. 1S5 before
state aforesaid, personally appeared -
who signed the foregoing receipt. in duplicate, in
my Presence; and ! cer:ify that he is the same
- who claims to have served Cd board the
United States ship -, in the Pacific, the
coast OF Mexico and California, in the years
To be signed by authenticating officer.
Duplicate receipts In the foregoing form are
auirei for each vessel and for each act when pay
IL mt is claimed under than one to be signed
by the claimant, or his attorney in his name. When
he IS to be paid through third party, in lieu of his
receipts, he must execute, substantially in the fol-
lowing form, power of ttorney, in which, ii there
be a valuable consideratDr named, it must not be
rested at the commence ment, is often done, or
over the top, but prescribed in the body of the
power.
Form for powcr Of attorney.
L, -,
being entitled to extra peJ, under the act of Con-
gress entitled San act making appropriations for the
naval service for the year e-Iding June 80, lS5 -
approved -, 1855 amounting to - dollars
IS -, on board the United States ship
which served in the Pacific ocean, on the coast of
California and Mexico, sire May Is, 1916, for and
in consideration of the sum Df -- dollars TO me
in hand paid, do hereby app int my attorney,
for me, and in my name, to demand and receive
FRI N the navy agent at Wa hington, D. c., or other
proper officer of the United States, the amount of
pay herein before rcted and to receipt there
for, hereby confirming al that my said attorney
may lawfully do in the pre- Aiises, as fully as L done
(signature.) Isl
Signed and sealed in our presence, this - day
Two winessGs.l
S4 County ., o., IS.
On this day Of, A. d. 1855 before me,
a-in and for the Stale and county aforesaid,
al officer having authority to take acknowledgment
OF deeds, personally appeared -, to whom read
and fully explained the foregoing power of attor
ney, and WHO signed and acknowledged the same In
my presence to be hiS free Get and deed and FUR
Tier certify that at the time of taking such acknow
edgment the power warrant OF attorney Aforesaid
contained neither blank, an interineation, nor an
alteration or if it did, describe the same according
to the racts, and that have annexed hereto lspe
cifying the papers no may affx
Justice Of the peace, or other magistrateJ
certificate Of identity from commissioned or
warrant officer of the navy will be required IN ALL
cases where the discharge is lost or mislaid in the
| following form:
certify that the signature to the within, re-
going annexed receipt in duplicate, or power Of
attorney, as the may be. is witnessed by me-
| that il was signed in my presence by -, who
| is well known to me the Identical perfon who
served by that name on board the United States
ship -. in the Pacific, as a -, in the year
-, aud who is named in the discharge herewith
an nexed. III the discharge he not produced, the
officer viii so vary the certificate to suit other
facts within his knowledge In reference 70 his dis
charge of service.
ITO be dated and signed by the officer, subjoining
his rank. p.