The free lance. (Fredericksburg, Va.) 1885-1926, 1900-04-17

l. -, DO certify lnht - HhO'N
name is signed to the foregoing applI-
cation. personally appeared before me
In my county Tor city aforesaid. and
having the aforesaid application read 10
him and fully explained, as well as the
statements and answers therein made
for the said -. made oath before
me that the said statements and answers
are true Given under my hand this
- day IF -, 100.
APPLICATION or WIDOWS.
or. A. a widow. she shall mako an
application in the following form J.
-, resident at --, In the county
q -. in the State Of Virginia, do
hereby apply fox aid under an act Of the
General Assembly, entitled an act to
give aid to soldiers, sailors and marines
II Virginia manned or disabled In the
war between the States and 10 the widows
Of Virginia soldiers sailors, and marines
who lost their lives in said war in the
military service, and DO swear that |
am the widow Of -. who was q
member Of -, and who, while IN
the discharge Of his duty in military
service during the late war between the
states. lost his life Of the husband OF
such widow died since the war her ap-
plication shall conform as nearly as pos
sible TO the form here provided, stating
the date % her husband 8 death, etc J
and that do further swear that | am
not receiving aid from any pension
from any State or from the United
States. and that do not hold any ma
tional, State, or county Office which pays
me In fees or salary over 5000 that my
income from no source amounts to
$500. and that | do not own in my
own right property Of the assessed
value Of 81 900. and that am now en-
titled to receive annually the sum OF
$50, under the terms Of the aforesaid act
of the General Assembly. And do
further swear that the folloSing answers
are true: CD What was the name Of ap-
plicant's deceased husband? (2) When
and where, as nearly as can be ascer-
tsined did the applicants husband die,
and from what cause? (S) When and
where were the applicant and her de.
ceased husband married? (4) Has the
applicant ever married again?
The application Of widow shall bo
certified and sworn to just as applica
tion Of soldier is required to be done
If the person making the application
has not been wounded, but bases bis
application upon the fact that he is dis
abled from disease and infirmities Of
age. his application shall conform as
nearly as may be to the application OF
a wounded soldier, and shall specifically
describe the disease and the nature aud
extent Of the disability, and shall be
signed and sworn to by the applicant
II any applicant is unable to write his
or her name, 1t shall be written by
some one who shall sign as witness
after the applicant has made his or her
mark. If the applicant is unable to
come before the board the clerk Of said
board. or any justice or notary shall
without compensation. secure the
signature Of the applicant and affidavit.
THE CHAIRMAN's CERTIFICATE.
.. After such application has been
signed and sworn to by the applicant,
the board hereinbefore provided shall
examine such evidence as shall be ad-
duced before it as to the facts set forth
in said application, and If IL be salts
fed from the evidence Of witnesses and
from such record evidence as toproperty
qualification as may be produced or ex-
amined. that the facts set forth in said
application are true, 1t shall certify on
the back Of the application In the fol-
loving form:
l., chairman Of the Confederate
Pension Board of - county Cor
city, do hereby certify that said board
has carefully considered and examined
into the within application, and being
fully satisfied from the evidence that
each and all the f acts set forth therein
are true; that the applicant is the
identical person named therein the
said application is for these reasons ap.
proved, and 1t is. therefore. certified
that Is entitled to receive an
nually from the State Of Virginia, the
cum Of s. This certificate shall be
signed by the chairman OF the board
and countersigned by the clerk there
of. IN the application Is not approved