holloway pension

8/6/2019 Holloway Pension

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Dear Patron:

We' regret that the enclosedphotocopiesare the best wewere able to obtain usingour normal reproduction process. This iscaused primarily by the age and fadedconditions of som e of the documents fromwhich these copies were made.

COMPLETE FILE ENCLOSEDBEST AVAILABLE COPY.


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Address your reply to the C O M M I S S IO N E R O fE N S I O N S "with return of this letter.

/ - i . - f .-f[ 0Vy\4txoC|A crvu C7


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SIS:

WAR DEPARTMENT,jjnrgeon (general'sRECORD AND PENSION DIVISION,

Washington, D. C.,I have tl/ie honor to return herewith your request for a report of hospital treatment in

Claim JVo. ^A(/j.. /Tr /lv , with such information as is furnished by the records filed inthis Office, viz: that _


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O (INVALID.)

PENSION OFFICE,

t e a tm e n J e n i,?a^Zstezz^L,

.&?b&s*>----._L^Qs&>\sn4~& /tfr-t-


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03"Address : "Chief of the Record and Pension Office ,War Department, Washington, D. C."

Respectfully referred to the] Cfii < f of theuecord and Pension Office , War Department,requesting a full military and medical history

(Descriptive list.)

* fc ' _ _ ' _ L - T ^ n r - ^ _ , ! . _ " . - _ l _ ll , ' ' - ! - ! . i _ ' n i j - - - , - \of the soldier.

Please examine all records likely to affordany information as to diseases, wounds, orinjuries incurred by him while in the service.

No other Keptort on file.

WAR DEPARTMENT,

Washington, _ ^ _ L : J _ _ _ i J l ,Respectfully returned to the

Commissioner of Pensions,with the information that . _ * * ;

BY A V I T H O K I T Y O F T H E S E C R E T A R Y O F W A K :

Colonel, U. S. Army, Chief of Off ice.(323)


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He further declares that he has been a practitio ner of med icine forJhe prosecution of this claim.

.years, and tha t he has no interest either direct or indirect in

'_ Affiant's signature. Give rank and service if in the army.]i*"" J Q i t*&J+-'Sworn to and subscribed before me , this .J day of fTl r/7.7. , A . D. \9>^*f., and I hereby certify that the affiant

is a practicing physician in good professional standing; that the contents of the above declaration, &c., were fully made known to him before swearing, in-

' ' " ' . < ' ^ K , jI1 'W S | l | M

l'fl ul ' , *, i . i I 3J t nuj * I! i> ,1, d i l l h i 11 1 ! 1 ' i i !H | i ' ' M ii* ' ft . '"

[ O f f i c i a l Title.]Clerk of the Court in and for aforesaid County

and State, do certify that **,//. -}* . Esq.,whohath signed his n ame to he/ (/ f) 0 /r- ^ " -~ st? s>foregoing declaration,and affidavit was at the time of so doing &....Mf:tf^f^2.^vi?.'."C,-^-/ ..tf^f-r?...^K/Cl^^ ^.T^t^'.f.^..hr."frn-.

in and for said County and State, duly comm issioned and sworn j'Xnat all his official acts are entitled to full faith and credit, and that his signature theretois genuine. , . ' . '

Witriess my hand and seal of office, this.,.fSEAL.]

H I M i iii,r f

,...day o f . . . ( * L . .

T>> t h i i t * nr .Tiistiff o/* the Fence. If b e f o r e _ a Xfi^,i i i n |i 'i [ ,

O

Se>o3rXJ

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^ IsC O **

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bQt~ S >h r f=> ^ | j,"ca MH 1 AS 1 SJ !> ^ gf^ I J . t^ a H^ r~ \ % ? &$ ( | S^ ^I I a^ -v LLJ'^C1 s* L^ ^.s -i "* 'C Q


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(3-145a.)

ACT OP JUNE 27, 189O.

INVALID PKNSION.

'; JSSV~/ank.Company,Regiment,

month, commencing ^ t - ._. /.../

I-/

Disabled

Name,P. O. ,

RECOGNIZED ATTORNEY.Fee,Articles filed,

Agent topay.-'_-' 189.

APPROVALS.189.2 i...3vL*4f^A^v.,Jf..:.:...._, & * * .ubmitted for

proved for

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(3-145 a.)ACT OF JUNE 27, 189O,

INVALID PENSION.

Rate, $ , per month, commencing. .

Disabled by

RECOGNIZED ATTORNEY.Fee,

P.-* < Agent to pay.

Articles filed, , 189.

APPROVALS.

// / legal Reviewer . , Medical Referee.

now pensioned under other laws. Last paid to , 18 , atPensioned from , 18 , at $ , for

SERVICE SHOWN BY RECORD.& < J ?ffc. -fC- , 18^.^?, honorably discharged

Re-enlisted . j f i , 18 , honorably discharged.^ , 18Declaration filed b^L^&t?^-.--./ , 189.G., alleges permanent disability, not due to vicious habits,

from


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( T K O . H . M O I M J A N . I I E N K Y P. DAVIS.

M O R G A N X D A V I S ,

X C1 /

ATTORNEYS A TLAW

;x (1 1- - --4^ C g4-


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rjQ

8-1081.

P E N S I O N E R D R O P P E D .

Knoxvi l le , Tenn

Th e Commiss i oner of Pensions.SIR: I have the honor to report that theabove-named pensioner who was last paid

h as been dropped because

^

United States Pension Agent.N O T E . E v e r y name dropped to t>e tl\ reported at once,and when cause of dropping ig death, state date of deathwhen fenown. o-9


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D E C L A R A T I O N F O R I N V A L I D ^ P E N S I O N . \f JtxrxS5?,180ONOTE.This can be executed before an y officer author ized to administer oaths fo r general purposes. If such officeruses a seal, certificate of Clerk of Court is not necessary. If no seal is used, then such certificate must be attached,

., 0s :tateON THIS-WC /. day of

personally appeared before me, awith in and for the County and State aforesaid,

, A. D. one thousand eight hundred and ninety.

i.years, a resident pf thei:i.;' s t a t e o f .-% County of -

* '- ?>dulyigworn aC9rd ing to law, aeclares that he is the ideiiticalX ^ S% rt /\*

( H e r > 6 state'rank, company and

< " , - V- in the war of the rebellion, and served at least

n ine t y days, ind wa s H O N O R A B L Y M S C H A R f i E D at --XZ .0?*?3,1U* 4&*


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4 -


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t - GE NE R AL AFFIDAVIT.0 ta te 5 5 :

ON THIS . r.Z -. .day of ... ..Z&&< .. A.K189/, persona l ly appe a r ed before me, a./ *" , /in and ror the aforesaid County, duly authorized to adminis t e r oa ths ,aged..o>xL-.years, a resideift of

0(5

in the County of /..s?*?*^..g&t*&c,.. and State of.whose Post-Office address is ..r^i2....


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< S. O -A^o personally appeared ..., residing at ( * !&~&M:


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a, pe r sons whom I certi fy to be

,. who , being by me duly sworn, say t ha t they were present an d saw'jsdtd/Yl/'." ' ^ , th e c l a imant , sign hi s n a m e (o r m a ke hi s m a r k ) to the

aregoing decla ration ; that they have every reason to believe f rom the app earance of said claiman t and their ac -qua in tance with him t ha t he is the identical person he represents himself to be; and that they Jiave no inte r e s t in theprose cut ion of this claim. ^

Sworn to and subscribed before me this f day of. tfefcQ 3J ,^ , (5

HS0)


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fur the r declare thaty^y ^ - . - . .no interest in said case and . . . . S r < C . . . . . . . . . . . . . . . . . no t concerned

NOTE.The witnesses i f no t t r remselves e q u a l to the Task o f d r aw i n g t h e a ff idav it s , sh o u ld go t o some N o t a r y P u b l i c ,J u s t i ce of the Peace, o r o t h e r officer o r co mp e t e n t p e r so n , an d h av e t h e b lan k f i l l e d o u t an d p r o p e r ly e x e cu t e d .

STATE OS- 1 -, C O U N T YSworn to and subscribed b e f o r e meihis day by the above-namedaffiant, and I certify that I read said af f idavi t to said

, including the words r^r.' ^^:^iL^^:&'.!f.f^ft---/^^.


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AFFIDAVITOF

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FLDB

JMCUS:

yPnpEminaaeAa

CMeoDivonnU.SPoB

WNODC


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ANCEODSALT

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o re CC 5 !^BP S> OtQF -g S

"- o 5 -3ar ,xT s~ . Br or 2 n ( o ts ^ o 3 p 3o 5B5rq r n o a

j i-J JX-l- i"t -8-^ ST. ^^&3 r cre oOB8a%o " ?e o^-t ocr o pcr 3? &1nV


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'Cmra

AddionalEvidence.

FLB

.Sen&O

WaClamAton

*-O

ORIGIN OF DISABILITY.NOTE.Tills affidavit must be executed by a Commissioned Officer, or First Sergeant, if possible; or if not possible to secu)timony ol such, then two of the soldier's comrad es should testify.

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: A. D. 18/'y? personally appeared before me ain and for the aforesaid County/duly authorized to a dminister oaths^f,-

aged (g /^Cyears, a resident of J---- who being' in the Countyol...l t l /SUd tO i r.. and Sta" ; j l - , ' ! , "i., 'duly sworn accruing to law, states that he is ' . " ' ' , > " > , ( ' . ' ' **Qf JO' _"who belonged-toGo'.* :^,.:..._......s2 .....Kegimen't'of . . . . . . . and who in the lijfe o f duty

in the State o f i Z & r - ^ . did , on or about the, beoome disabled in the fo l low ing manner, viz :

[Hero state J iow, when an d where tie wound or injury wa s received, t i V e part b i tn e b b ' uy w o u^^^

-[If sicsnetis, BtateAvhen, v^Jiere tol under whalôu-oumstances contracted, wât c a u s e c t , he name or nature ofa ^ o u o u m s a n c e s contracted, wât causecyt, the name or nature of tbe-gte

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(If affiant sign liy mark, two persons who can write sign here.)Sworn to apd subscribed before me^by the above-namedaff iant this /../.._ day ofand I certify that I read said affidavit to said affiant, including the words ,

erased; and the words addidand acquainted him ;ffith,4J&j&ate!p&bf]%Ml^^^ certify, that'I-aia-iirno'wise'iHtWestedin said case, nor am I concerned in-its-prosecution; and that said aff iant is personally know to me_aniLthat he is acredible person. C/4sJ A

sA ^fflliia-1 Signature. _tZll^i('Official Character.) ~

.. Clerkof the Court in and fo r aforesaid County and, Esq., who hath signed his name to the

foregoing declaration andvaff idavit was at the'time^-oi so doing &.U^^^^^^^ ,....> ,... f z , df~Z&^cJ(Lje-i'n and for said Coun ty .and State, duly commissioned and swonr; that all his official acts are entitled to fu l l faithand credit, and that his signature thereto is genuine.

":V7.State, do certi fy

Witness my hand and seal of office, this[L. S.]

Clerk of the

NOTICE.This should be sworn to before a C L E R K O F C O U R T , N O T A R Y P U B L I C , or J U S T I C E O F T H E P E A C E . Itbetorea N O -T A R Y (tvithout a sealjor J U S T I C E , the C L E R K O F C O U R T must afld Ms certificate of official character hereon, and not on a separate slipof paper unlessa general certificate of official character has alreadybeen fllefl in the DepartmentatWashington.

-Mr o i.*"""'t ?> 1-< f ,Q \wiil . _ v .. ^" i

CO3 t m -S.^ Q h-U l r \g Its tH

A F F I D A V I T F O R C O M M I S S I O N E D O F F I C E R O R C Q M R A B f r B f r L;"l/ -" >5 'i C S K E E 1 : JOT7 1 / - s, ,.- 'if-l l i > ' c n - :V^/1 .,_-.. iC O U N T Y O FIn the Pension Claim of came before me,

w

(.flame ol Claimant.)


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(Name of Affiint.)an d for aforesaid County and State..Regiment of

, and now a resident of...(Give efiyVVfllage or Town; il in'the city, give name ol street ana nnmber ol house,)z yState of. J^L*6t^^X&iLJi*&&iidLisssasi*~~^ wel l known to me to be

J Y ' reputable an d entit led to credit, an d who, being duly sworn, declares in ; the aforesaid xase,,s,follow's: . i k , vin Companyhat....

of -the,(Name of Claiman

. ~t.) / X* xT .

..Regiment of ...- *...:zx.z.fai.?.fr.~.. ..^.Voluiiteefs of the war of 1861, while. V' *' ' ', /

holloway pension

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