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18-; and I certify that the claimant and witnesses are credible and worthy, and that the foregoing declaration and affidavit were carefully read to them before signing.

[O.fficial Signature.] STATE of County of

I hereby certify that before whom the foregoing afi davits were made, is a in and for the County of and State of duly authorized to administer oaths, and that his signature thereunto is genuine.

In testimony whereof I have hereunto set my band and official seal, this day of

18–. (L. 8.)

[ Official Signature.) NOTE8.-1. Attestation of signatures by mark () must be by written signatures 2. In the blank space desiguated by an asterisk (*) is to be written the word siare, or free, as the fact may be.

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Mother's Application for Arrears of Pay and Bounty. STATE OF County of

} On this day of

18, personally appeared before me, a

in and for the county and State aforesaid, of in the county of —, and State of who, being July sworn, deposes and says that she is a * -person of color; that ber age is

yeurs: and that she is the mother of —, deceased, late a residen, of in the State of -, who was a in company

of the regiment United States colored troops, who enlisted at in the State of on or about the day of

18–, and who died in the service of the United States at on or about the day of —, 18, Leaving neither wife, child, nor father. That the name of the father was

and that on or about the day of ...., 184, the said

Sbe further makes oath that her said son was & person, and had been since the day of — 18—, she makes this application to recover all arrears of pay, bounty, and other allowances due the deceased from the United States, and desires that the certificate of pay, when issued in satisfaction thereof, may be sent to her at

post office, county of and State of Signed in presence of

[Signature of Claimant.] Also personally appeared

and of —, in the county or and State of who, being duly sworn, depose and say that they are personally acquainted with the abovenamed applicant, who is a *. person of color, and were also well acquainted with deceased, who was a - in com

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of the regiment colored troops, and knon the said to be the mother of the said who died in the service of the United States, as above stated, leaving neither wife, child, nor father. That the name of the father was and that on or about the

day of

- 18-, the said They also make further oath that the said person at the time of entering the service of the United States, and had been since the day of 18-; and that their knowledge of these facts is derived from intimate acquaint ance, having lived within miles of the claimant and family for the last years. They also declare that they have no interest whatever in this application. Signed in presence of

[Signatures of Witnesses.] Subscribed and sworn to before me, this

day of 18—; and I certify that the claimant and witnesses are credible and worthy, and that the foregoing declaration and affidavit were carefully read to them before signing.

( Official Signature.] STATE OF County of

I hereby certify that — before whom the foregoing affidavits were made, is a in and for the county of -, and State of

duly authorized to administer oaths, and that his signature thereunto is genuine.

In testimony whereof I have hereunto set my band and official Scal, this

day of

18L. 8.)

[Official Signature.] NOTH0.-1 Attestation of signatures by mark (*) must be by writion signatures

2 In he blank space designated by an asterisk (*) is to be written the word slace, or free as the fact may be.

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day of

a

Application of Brothers and Sisters for Arrears of Pay and

Bounty.
STATE OF
County of
On this

-, 18–, personally appeared before me, in and for the county and State aforesaid,

who, being duly sworn, deposes and says that they are persons of color; and are the brothers and sisters of —, deceased, late a resident of in the State of

who was a

in company

the regiment United States colored troops, who enlisted at , in the State of -- ., on or about the

184, and who died in the service of the United States at on or about the day of — 18–, leaving neither wife, child, father, mother, nor any other brother or sister, eitber of the full or half blood.

7

day of

was a

*

We further make yath that the said

person at the time of entering the service of the United States, and had been a -- since the day of

184 We make this application to recover all arrears of pay, bounty, or other allow. ances dut the deceased from the United States, and desire that the certificate of pay, when issued in satisfaction thereof, may be sent to at post office, county of and State

9

of .....

was a

*

Signed in presence of

[Signature of Witnesses.) Also personally appeared and —,of—, in the county of

and State of —, who, being duly sworn, depose and say that they are well acquainted with all of the above-named claimants, who are * -persons of color, and know that they are the brothers and sisters of deceased, who was a in company of the regiment United States colored troops, and who died in the service of the United States, as above stated, leaving neither wife, child, father, mother, nor any other brother or sister, either of the full or half blood.

They also further make oath that the said person at the time of entering in the service of the United States, and had been — since the

day of

18—; and that their knowledge of these facts is derived from intimate acquaintance with the claimants and deceased, having lived within miles of them for the last years, and were acquainted with their parents in their lifetime. They also further declare that they have no interest whatever in this application. Signed in presence of

[Signature of Witnesses.] Subscribed and sworn to before me, this 18–; and I certify that the claimant and witnesses are credible and worthy, and that the foregoing declaration and affidavit were carefully read to them before signing.

[Official Signature.[ STATE OF County of

I hereby certify that -, before whom the foregoing affidavits were made, is a in and for the county of --, and State of

duly authorized to administer oaths, and that his signature thereunto io genuine.

In testimony whereof I have hereunto set my hand and official eal, this

day of (L. 8.]

[Official Signalure.]

day of

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18

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NOTEB.-1. Attestation of signatures by mark (M)must be by written signatures

2. In blark sprice designated by an asterisk (*) is to be written the word slave, cr fred as the fact may be.

& Vame, age, and residence of each of the claimants to be stated in the declaraHon. Minor hoirs must apply through a guardian duly appointed, who will append bo his application certified copies of letters of guardianship.

88.

*

was a

1

Application of Children for arrears of Pay and Bounty.
BTATE OF
County of

}
On this day of

18—, personally appeared before me in and for the county and State aforesaid, who, being duly sworn, deposee and say that they are

persons of color and are the children of —, deceased, late a resident of

-, ir the State of who was a in company

of the egiment United States colored troops, who enlisted at in the State of —, on or about the day of —, 18—, and who died in the sepvice of the United States at on or ahout the .... day of —, 18--, leaving neither wife nor other child. We further make oath that the said

person at the time of entering the service of the United States, and had been a since the day of

18–

We make this application to recover all arrears of pay, bounty, or other allowances due the deceased from the United States, and desire that the certificate of pay, when issued in satisfaction thereof, may be sent to at the post office, county of -, and State of Signed in presence of

[Signature of Claimants.] Also personally appeared

of

in the county of and State of who, being duly sworn, depose and say that they are well acquainted with all the above-named claimants, who are persons of color, and know that they are the children of deceased, who was a —

in company of the regiment United States colored troops and who died in the service of the United States, as above stated, leaving neither wife nur other child.

They also further make oath that the said 'erson at the time of entering tbe Service of the United States, nd had been since the

18-; and that their knowledge of these facts is derived fronı intimate acquaint ance with the claimants and deceased, having lived within miles of them for the last

years, and were acquainted witb their mother in her lifetime. They also further declare that they have no interest whatever in this application. Signed in presence of

[Signatures of Witnesses. Subscribed and sworn to before me, this

day of 18–, and I certify that the claimant and witnesses are credible and worthy, and that the foregoing declaration and affidavit were carefully read to them before signing.

[Official Signature]

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day of

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STATE OF
County of

I hereby certify that -, before whom the foregoing affirlavita were made, is a in and for the county of and State of

-, duly authorised to administer oaths, and that his signature thereunto is genuine.

In testimony whereof I have hereunto set my hand and official seal, this

18– (L. S.]

[Official Signature.]

day of

Notes.--1. Attestatim of signatures by mark (*)must be by written signatures.

9. In the blank space designated by an asterisk (*) is to be written the word slave, or free, as the fact may be.

8. Namo, aga nnd residence of each of the claimants to be stated in the declara. tion. Minor heil a must apply ihrongh a guardian duly appointed, who will append to his application sertified copies of letters of guardianship.

With each and every application for pay and bounty due a colored soldier the attorney presenting the same must file his oath or affirmation that he has no interest whatever in said pay ( I bounty beyond the fees for the collection of the same as fixed and established by law. The failure to file such oath or affirmation will in eves y case result in the suspension of the application,

Application of Discharged Soldier for Additional Bounty

under Act of July 28, 1866. If this declaration is made before a justice of the peace or notary public, it must be certified to by the clerk of the proper court that such justice or notary was duly commissioned at the time. The seal of the court should be stamped on the original paper, or, if on an attached certificate the impression should appear on the original. Wbere claimant cr witness, or either, bigo by mark, two disinterested witnesses who can write must attest the same. Applications executed before a notary public wbo hus i certified copy of his commission on file in the departnent, with his signature and impress of lis official seal thereon, Deed 1.0t be certified by a court of record. STATE OF County of

} On this day of — 18—, personally appeared beforo

in and for the county and State aforesaid, -, of in the county of —, and State of personally known to me, who being duly svoru according to law, declares that bis years, that he is a resident of

88 :

corinty of State of -, and that he is the identical who was cnlisted

me, a

Age is

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