(:('l'NT)' 0/; __ __________ ___________ ._.
t;,I"r: Alldi/(lr of llu Siaft' 0/ No,III GmJ/illn:
\\"e certify tha t we have carefully examined the applicatioll of
Ivr a I)(;usioll llllder the pro\'i~iolls of au act cutllled "Au Act to allie-lid chapter I yS of the La\\',~ of Iss9, for the rdi.:f 01 certain Cunt"d-
~'rate Soldicr!'\:ul(l Widow!\," rati6~d March 2, t901, I" the idl'lItkai per:;Oll who clllbted ill Co __ • _. _" ____ A _" _ ••• " ___________ ~
Reg"t oL _______ Troops, Oil or about tile _______ A __ day oL_. ___ • _________________ 186 __ : aUlI who wa!-\ dislUlf't\ ii, lIIall11E"r ~"!'
f~lt" cxtf>1\t ... t~I'''\ j" tho> ("r<'gr ":':; ce:li!k:ltc$v[ hil!lit.lf .. wi i,i'),l>ic'.m ill COIl~~l uellce 01 a wound rctC'l\"e<i ill h;ntle on or ."b ,lit the
______ _____ d::ayoL_ ---- - --- - ---- _________ _______ .186. ; lllld Wl certify the following allegntionoShct forth in hi,,; npplicatiun lu
hl true, namely 1'hat he is, and lia., bt...>tn for tweh-e months I!nmediately preeeding thi:. Application for l'ell!\ion, a /""/(1 .fid~ re!\icellt c.
t\orlh Carolina, that he holds no office under the Cuiled Stale-; or uuder any State or County, from which he is re<'t'i,"ing the ;,t:11I of
thn..-e hundred dollars as fcc.s or ll~ a salary ann ualIy: that he is 1I0t worth in hi!l own right or th~ ri~ht of his wife. prop"rt)" at its :l"!"f""'­so.:
d \'allle for taxation to the amount offi\"l.: hundrvl doll.ITS ($500), nor has he disposed of propE'rty of ~uch \'::a\t,e hy gift or \"dl:ut:ay
"o1l\·eY·lllce since the 11th day of March, 18SS. :"iml th:1t he i'lllol rct'Cidng aid from any other ~urcc fr0111 the Slate of Xorth Carolina,
lIul Ilwn.;fore hi~ appliclltion i!. rorrl."<:t and just under the act.
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