Chap. 159.—An ACT to amend and re-enact sections 1 and 2, as amended by act
of general assembly approved March 15, 1904, and sections 1, 2, 4, 7, 14, 15,
16, 18, and 20 of an act entitled: An act to aid the citizens of Virginia who
were disabled by wounds received during the war between the States while
serving as soldiers, sailors or marines of Virginia and such as served during
the said war as soldiers, sailors or marines of Virginia who are now disabled
by disease contracted during the war or by the infirmities of age, and the
widows of soldiers, sailors or marines of Virginia who lost their lives in
said service or whose death resulted from wounds received or disease con-
tracted in said service, providing penalties for violating the provisions of
this act as amended by previous acts and by subsequent acts and by the act
approved March 10, 1906.

Approved March 10, 1908.

1. Be it enacted by the general assembly of Virgina, That section one
and section two, as amended by act of the general assembly approved
March fifteenth, nineteen hundred and four, and sections one, two, four,
seven, fourteen, fifteen, sixteen, eighteen and twenty of an act entitled
“an act to aid the citizens of Virginia who were disabled by wounds
received during the war between the States, while serving as soldiers,
sailors or marines of Virginia, and such as served during the said war
as soldiers, sailors or marines of Virginia who are now disabled by
disease contracted during the war or by the infirmities of age, and the
widows of soldiers, sailors or marines of Virginia who lost their lives
in said service or whose death resulted from wounds received or disease
contracted in said service, providing penalties for violating the provisions
of this act as amended by previous acts and by subsequent acts and by
the act approved March tenth, nineteen hundred and six,” be amended
and re-enacted so as to read as follows: ;

Class A.—To every person who has lost two eyes, or two feet, or two
hands, or a-hand and a foot, by reason of wounds received, or surgical
operation therefor, while in the discharge of his duty as a soldier,
sailor or marine of Virginia in the war between the States, and any such
as have become totally blind by disease, the sum of one hundred and
fifty dollars per annum.

Class B.—To every person who has lost an arm, or a leg, or a foot,
or a hand, while in the discharge of his duty as a soldier, sailor, or marine
of Virginia in the said war, the sum of sixty-five dollars per annum.

Class C.—To every person who is disabled by wounds received, or
surgical operation therefor, while in the discharge of his duty as a
soldier, sailor, or marine of Virginia in the said war, or is disabled by
disease, if such disability be proved to be total, the sum of thirty-six
dollars per annum, and if such disability be proven to be partial, the
sum of twenty-four dollars per annum.

Class D.—To every person over the age of sixty-five years who was
loyal and a true as a soldier, sailor, or marine of Virginia during the
said war, and who by reason of the infirmities of age has become dis-
abled and incapable of earning a livelihood, if such disability be proven
to be total, the sum of thirty-six dollars per annum, and if such disa-
bility be proven to be partial, the sum of twenty-four dollars per annum.
Class E.—To every widow, remaining unmarried, of any soldier,
sailor, or marine of Virginia, whose husband lost his life while in the
discharge of his duty in the military or naval service of Virginia during
the said war, who is now a widow, although she may have married again,
the sum of forty dollars per annum.

Class F.—To every widow of any soldier, sailor, or marine of Vir-
ginia, whose husband was loyal and true in the military or naval service
of Virginia during the said war and has since died, who is now a
widow, although she may have married again, the sum of twenty-five
dollars per annum.

2. This act shall apply to every citizen of Virginia who was a resi-
dent thereof April first, eighteen hundred and sixty-one, and to the
widows of such as are dead, and to the soldiers, sailors and marines of
cece ee eee eee eee eee aes , and of any other States composing the
Confederate States, that allow pensions to former citizens of Virginia
who were in said service, who have been bona fide and continuous actual
residents of Virginia for five years next before the passage of this act, as
hereinbefore classified, who entered frem this or any other State, in the
military service of the Confederate States, and who is or shall be at the
date of his or her application, for the benefits of this act, a citizen and
actual resident of Virginia, as hereinbefore providéd, but no person
holding a national, State, or county office, which pays a salary of two
hundred dollars per annum or whose income from any source whatever
is two hundred dollars per annum, or who receives from any source
whatever money or other means of support amounting in value to two
hundred dollars per annum, or who owns in his or her own right, or
where there is held in trust for his or her own benefit, or where the
wife owns, or there is held in trust for her benefit, estate or property,
either real, personal, or mixed, in fee or for life of the assessed value of
seven hundred and fifty dollars, or who is in receipt of aid or a pension
from any other State, or from the United States, or from any source
whatever, or who is in inmate of soldier’s home, shall be entitled to the
benefits of this act. But a soldier, sailor, or marine who is entitled to
be placed in class A or B shall have the amount hereinbefore provided
for him, unless he or his wife has an estate of the assessed value of one
thousand dollars, but also that a soldier, sailor of marine who has reached
the age of eighty years shall have the amount hereinbefore provided for
him, unless he or his wife shall have an estate of the assessed value of
fifteen hundred dollars, provided, that the actual amount due or un-
paid upon any deed of trust or mortgage to secure the payment of a
debt shall be deducted from the assessed value of the property of claim-
ant under this act. ;

In computing the value of the estate held by any person or for his
or her benefit under this section all property conveyed by deed for
consideration not deemed valuable in law or parted with by gift since
March second, nineteen hundred and two shall be considered as his or
her estate.

4, That the said applications, affidavits. and certificates shall be in
form and substance as follows:
Application of Soldier, Sailor, or Marine for Disability by Wound.

Tyas bn oie we ee ence noe ies a » do hereby apply for aid under the act of the
general assembly of Virginia, approved (the auditor will insert in
printed blank the title and date of the approval of this act), and I do
solemnly swear that I am a citizen of the State of Virginia and res-
ident at ................ 9 WH the win sisniwsaei chews of ......- Pea
cece eee eee eee in the said State, and that I have been an actual
resident of the said State for two years, and of the said (city of county)
for one year, next preceding the date of this application, and that I
was a (state here whether soldier, sailor, or marine) of the State of Vir-
ginia in the war betweeen the United States and the Confederate States,
and that while in the discharge of my duty in the service of the Confed-
erate States as a member of (here state specifically the command and
branch of the service to which the applicant belonged and the names of
his immediate superior officers), and that on or about the.......... wa.
Of winecuvansawies , 186.., I was wounded (here state specifically the
battle, combat, or encounter in which the applicant was wounded), and
that from the effects of such wound I was permanently disabled, as fol-
lows: (here state specifically the character of the wound and the disability
occasioned thereby, and whether such disability is total or partial) ; and
that during the said war I was loyal and true to my duty, and never
at any time, deserted my command or voluntarily abandoned my post
of duty in the said service and that by reason of such disability I am
now entitled to receive, under the said act, the sum of ................
dollars annually. And I do further swear that I do not hold any
national, State, city or county office which pays me in salary or fees two
hundred dollars per annum; nor have I an income from any other em-
ployment or other source whatever which amounts to two hundred
dollars per annum; nor do I receive from any source whatever money
or other means of support amounting in value to the sum of two hun-
dred dollars per annum; nor do I own in my own right, nor does any
one hold in trust for my benefit or use, nor does my wife own, nor does
any one hold in trust for my wife, estate or property, either real, per-
sonal, or mixed, either in fee or for life, of the assessed value of seven
hundred and fifty dollars; nor do I receive any aid or pension from any
other State, or from the United States, or from any other source, and that
I am not an inmate of any soldiers home, and I do further swear that the
answers given to the following questions are true:

First. What is your age? ,

Second. Where were you born?

Third. How long have you resided in Virginia?

Fourth. How long have you resided in the city or county of your
present residence? ;

Fifth. What is your usual and ordinary occupation for earning a
livelihood ?

Sixth. How long have you followed such occupation or employment?

Seventh. Have you followed such occupation or employment, or any
other occupation or employment, within the last two years? If so, state
when and where, and the amount of your annual income from the same?

Eighth. Are you totally disabled from following your usual and
ordinary occupation or employment, or any other occupation or em-
ployment, by which you can earn a livelihood? If not totally disabled.
but partially, state the extent of your partial disability.

Ninth. When and where did you enter the service of Virginia, or of
the Confederate States?

Tenth. To what command and service were you first assigned, and
who were you immediate superior officers?

Eleventh. In what command and service were you when wounded,
and who were your immediate superior officers?

Twelfth. How long were you in the service?

Thirteenth. In what battle or combat were you wounded, and under
what circumstances were you wounded ?

Fourteenth. What was the precise location and nature of your wound,
and if more than one wound, how many, and the precise location and
nature of each?

Fifteenth. What limb, if any, did you lose by reason of the said
wound ?

Sixteenth. Did you lose your sight by reason of the said wound ?

Seventeenth. If sight or limb was not lost, what is the precise nature
of your disability caused by any wound or wounds received in said
service, and in what way are you disabled by it?

Eighteenth. Give the names and addresses of two or more survivors
of your command when you were wounded, if any such be living, and
if not, so state.

Nineteenth. Give here any other information you may possess relating
to your service, or wound, or disability that will support the justice of
your claim for aid.

Twentieth. Is there any camp of Confederate veterans in the city or
county of your residence?

Twenty-first. Is there any one living, the residence and address of
whom is known to you, either comrade or otherwise, who has knowledge
of your service and of the cause of your disability? If or not, state.

Twenty-second. If disability was occasioned by surgical operation
for a wound, so state, and wherein such operation caused your disability.

Witness my hand this.........-.--4- May Of. cw swcecceese ws 190..

Tos casam im semse mew reas Pe in and for the........
0) , in the State of Virginia, do certify that..........
eT eee whose name is signed to the foregoing application
personally appeared before me in my.................... aforesaid,
and having the aforesaid application read to him and fully explained,
as well as the statements and answers therein made, the said..........
made oath before me that the said statements and answers are true.

Given under my hand this .......... day of............ , 190..
We,

in the said State, and that we have known personally and well for......
VEATS.... cece eee ee » whose name is signed to the annexed application
for aid under the act of the general assembly of Virginia, approved
(auditor will insert in printed form the date of the approval of this act),
and that the said...................05. is a resident of the said
county, and is a man of good reputation for truth and honesty, and that
we have read the annexed application and the answers to the questions
therein propounded made by the said applicant, and verily believe that
the said applicant has been truthful in the said statements and answers,
and that from our personal knowledge the applicant is disabled (state
the character of the disability, and whether it is partial or total), and
that we verily believe the said applicant is justly entitled to aid under
the said act, and that we have no personal interest in the allowance of the
applicant’s claim.

Subscribed and sworn to before me, a......... cece eee cece eens for
the ...........00. 0) rr , State of Virginia, this..........
May Of cas cwseesws ewes 190...

(D)
Affidavit of Comrades.

We, ..... 0... eee eee Leeee and ........ eee eee eee eee , do solemnly
swear that we are residents of the .......... of Lo... ee eee » in the
State of .cecenewswncwsas atid that os..ccedenseenwse > whose name

is signed to the annexed application for aid under the act of the general
assembly of Virginia, approved (auditor will insert in printed form the
date of the approvel of this act), is personally well known to us, and
that we have known him well for ........ vears, and that we were (state
here whether soldiers, sailors, or marines) in’ the military or naval service
of the State of Virginia, or of the Confederate States, during the war
between the United States and the (Confederate States, and that the
SAI. weowiewseusnswns . who was also a (state whether soldier, sailor,
or marine) in the said service during the said war, and was with us
members of (here state the command and the immediate superior
officers), and that to our personal knowledge the said applicant was
wounded on or about the ........... day of ...........006. ; _
at (here state the battle or combat where the wound was received and the
circumstances attending the wound), and that the said ..............
was a true and loyal (state here whether soldier, sailor, or marine) in
the said service, and that at the time the said wound was received the
said applicant was in the faithful discharge of his duties as such (state
here whether soldier, sailor, or marine) in the said battle or combat,

ne that we lave no personal interest in the allowance of the applicant’s
claim.

a

Subscribed and sworn to before me, a ............ eee eeeee for the
ye BB esas yet wsesinn spe of ................., State of Virginia, this

(C)
Affidavit of Witnesses, Not Comrades, as to Wounds.

Weis a bi 8. Ce odin Bie wy oad ADD, Sik eR teem » do solemnly
swear that we are residents of the............. Of ...... eee eee > in
the State of ............ , and that we personally know and are well
acquainted with ..............e ee eee » whose name is signed to the
annexed application, and who is applying for aid under the act of the
general assembly of Virginia, approved (auditor will insert in the printed
form the date of the approval of this act), and that we have known
the said applicant for ............ years, and that to our personal
knowledge the said .............. was a loyal and true (state here
whether soldier, sailor, or marine) in the military or naval service of
Virginia, or of the Confederate States, in the war between the States,
and was such when disabled, and that the said .................. was
wounded while in the discharge of his duty as a (state here whether
soldier, sailor, or marine) in the said service on or about the ..........
day Of cwsseseesersns , 186.., at (here state the battle or combat
where the wound was received, the nature of the wound, and the disa-
bility occasioned thereby), and that we have no personal interest in the
allowance of the applicant’s claim.

ee ey

Subscribed and sworn to before me, a......... Tawaw in and for the
Leen eee ees of .............., State of Virginia, this..........
day Of ssemew mins ens , 19

(B)
Certificate of Physician.

| > a practicing physician In the .cesenqews ews
Of seeimacmemmsaees , in the State of Virginia, do certify that I
am personally acquainted with .................. whose name is

signed to the annexed application for aid under the act of the general
assembly of Virginia, approved (auditor will insert in printed form the
date of the approval of this act), and that from a personal examination
of the said ...........4.. , as to the disability set forth in his appli-
cation and the cause thereof, I am clearly of the opinion that he is
disabled by reason of (here state specifically the nature of the disa-
bility and the cause thereof, and if such disability be total, whether the
applicant is deprived thereby of all ability to pursue his usual and ordi-
nary occupation for a livelihood, or any other occupation for a liveli-
hood, and if the disability be partial, to what extent the applicant is
hindered thereby from pursuing such occupation as aforesaid), and that
I verily believe his disability is wholly due to causes assigned in the said
application, and that he is entitled to aid under the provisions of the
said act, and that I have no personal interest in the allowance of the
applicant’s claim

Given under my hand this .......... day Of scsiswissanswe 7 1955

(E)
Certificate of Camp of Confederate Veterans.

THE wien cea ee camp of Confederate veterans of the .............
Of sesemiasamiwnsrms » In the State of Virginia, hereby certifies that
it has examined into the merits of the annexed application of .........
for aid under the act of the general assembly of Virginia, approved
(auditor will insert in printed form the date of the approval of this act),
and being satisfied of the justice of his claim, hereby recommends the
said ....... eee ee eee for aid under the provisions of the said act, and
that it has no personal interest in the allowance of the applicant’s claim.

ec

Commander.

(F)
Certificate of Hx-Confederate Soldiers.

We, ... cece ee eee eee ANd waseswacmewaewss , of the .........
Of wimewmecw em sew ew news State of Virginia, do certify that we were
(soldiers, sailors, or marines) of Virginia in the war between the States,
and that we have examined into the merits of the annexed application
Of .... see eee eee for aid under the act of the general assembly of
Virginia, approved (auditor will insert in printed form the date of the
approval of this act), and that we are satisfied of the justice of his
claim, and recommend the said .............. for aid under the pro-
visions of the said act, and that we have no personal interest in the
allowance of the appplicant’s claim.

Given under our hands this ......... day of ..........06. 5, 19: «,
(G)
Certificate of the Commissioner of the Revenue.
| , commissioner of the revenue in the ........
Of iasieimwiane , in the State of Virginia, do certify that............

to the annexed application for aid under the act of the general assembly
of Virginia, approved (auditor will insert in the printed form the date
of the approval of this act), is charged on the land and personal property

books of the said ............006. with estate, real, personal, and
mixed, of the assessed value of ...... ee dollars
Given under my hand this .......... day Of asusemiwni aves g 19:5

er

Form No. 2.
Application for Disability by Reason of Disease or the Infirmities of Age.

I, ceswscsscmeae ews , do hereby appiy for aid under the act of the
general assembly of Virginia, approved (auditor will insert in printed
form the title and date of the approval of this act), and I do solmnly
swear that I am a citizen of the State of Virginia, resident at ,

ey

in the cies essesausas OL scaiacewsneews > 1n the said State and that I
have been an actual resident of the said State for two years, and of the
5 (0 one year, next preceding the date of this ap-

now does any one hold in trust for my benefit or use, nor does my wife
own, nor does any one hold in trust for my wife, estate or property,
either real, personal, or mixed, either in fee or for life of the assessed
value of seven hundred and fifty dollars; nor do I receive any aid or
pension from any other State or from the United States, or from any
other source, and that I am not an inmate of any soldier’s home ; and
I do further swear that the answers given to the following questions are
true:
First. What is your age?

Second. Where were you born?

Third. How long have you resided in Virginia?

Fourth. How long have you resided in the city or county of your
present residence?

Fifth. What is your usual and ordinary occupation for earning a
livelihood ?

Sixth. How long have you followed such occupation or employment?

Seventh. Have you followed such occupation or employment, or any
other occupation or employment, within the last two years? If so,
state when and where, and the amount of your annual income from the
same?

Eighth. State specifically the nature of your disability or disease.

Ninth. What were the causes which led to the disease which has
resulted in your disability ?

Tenth. How long have you suffered from such disease, and when did
you first become aware that you were afflicted with the same?

Eleventh. With what disease or sickness did you suffer during the
time of your service?

Twelfth. Are you totally disabled because of such disease or the in-
firmities of age, from following your usual and ordinary occupation or
employment, or any other occupation or employment, by which to earn
a livelihood? Tf not totally disabled thereby, but only partially, state
the extent of your partial disability.

Thirteenth. When and where did you enter the service of Virginia,
or of the Confederate States?

Fourteenth. In what command or service were you engaged during the
war between the States?

Fifteenth. How long were you in the service?

Sixteenth. When did you leave the service, and under what circum-
stances ?

Seventeenth. If suffering from disease, state what physician or phy-
sicians have attended you for the same? ,

Eighteenth. Give the names and addresses of two or more in the
service of your command, if any such be living, and if not so state.

Nineteenth. Give here any other information you may possess re-
lating to your service or disability that will support the justice of your
claim for aid.

Twentieth. Is there any camp of Confederate veterans in the city
or county of your residence?

Twenty-first. Is there any one living, the residence and address of
whom is known to you, either comrade or otherwise, who has knowl-
edge of your service and of the cause of your disability? If so or not,
state.

Witness my hand this............... day Of. sora newem cee , 190..

The jurat of the applicant shall be in the same form as prescribed
for Form No. 1.
This affidavit shall be in the same form as prescribed for Form No. 1.
(B)
Affidavit of Comrades.

Wey... eee e eee and....... eee ee eee , do solemnly swear
that we are residents of the............... 0) , in the
State of............ 0. eee eee , and that...... Serer » whose

name is signed to the annexed application for aid under the act of the
general assembly of Virginia, approved (auditor will insert in printed
form the date of the approval of this act), is personally well known to
us, and that we have known him well for.................. years, and
that we were (state here whether soldiers, sailors, or marines) in the
military or naval service of Virginia, or of the Confederate States,
during the war between the United States and the Confederate States,
and that the said applicant, who was also a (state whether soldier, sailor,
or marine) in the said service during the said war was, with us, mem-
bers of (here state command and immediate superior officers thereof),
and that the said................000. was a loyal and true (state here
whether soldier, sailor, or marine) in said service, and faithful in the
discharge of his duties, and that we verily believe he is disabled from the
causes, and in the manner in his application stated, and that his claim
is just, and that we have no personal interest in the allowance of his
claim under the said act.

Ce

ec

Subscribed and sworn to before me...............-02 0000 , of the
fuiasa wie ema H of.............., State of Virginia, this...........
day of............06. , 190

(C)

Affidavit of Witnesses, not Comrades, as to the Service and Disability of
the Applicant.

We; seianiaiawsawsssws ANd se wswiwerwerewen wee ; do solemnly swear
that we are residents of the............... Of sawswscegeane wes ; in the
State of............. ee eee , and that we personally know and are well
acquainted with............... , whose name is signed to the annexed

application, and who is applying for aid under the act of the general
assembly of Virginia, approved (auditor will insert in printed form
the date of the approval of this act), and that we have known the said
applicant for.............-- ‘years, and that to our personal knowl-
edge the said applicant was a loyal and true (state here whether soldier,
sailor, or marine) in the military or naval service of Virginia, or of
the Confederate States, in the war between the States, and was faithful
in the discharge of his duty, and that we verily believe he is disabled
from the causes, and in the manner in his application set forth, and
that his claim is just, and that we have no personal interest in the al-
lowance of his claim under the said act.

Subscribed and sworn to before me, a ...........645 in and for the
Lecce eeee of .............., State of Virginia, this..........

(D)
Certificate of Physician.

This certificate shall be in the same form as prescribed for Form.
No. 1.

(#1)
Certificate of Camp of Confederate Veterans.
This certificate shall be in the same form as prescribed for Form
No. 1.
(F)
Certificate of Hx-Confederate Soldiers.

This certificate shall be in the same form as prescribed for Form
No. 1.
(G)

Certificate of Commissioners of the Revenue.

This certificate shall be in the same form as prescribed for Form
No. 1.
ae Form No. 3.

Application of Widow.

Lecce eee e eee in the ............, in the said State, and that I
have been an actual resident of the said State for two years,
and of the said ..........---- for one year, next preceding the date
of this application, and that I am the widow of .............. » who
was a (state here whether soldier, sailor, or marine) in the service of
the State of Virginia in the war between the States, and who was a
member of (here state specifically the command and branch of the
service to which the hushand of the applicant helonged, and, if possible,
228 ; ACTS OF ASSEMBLY.

the names of his immediate superior officers), and who, while in the
discharge of his duty in the military or naval service of the State of
Virginia, or of the Confederate States, during the said war, lost his
life (if the husband of such widow was killed or died during the war
as the result of wounds received, state the facts of the case as near as
possible, giving the date of the husband’s death, and if the husband
died after the war, strike out all relating to his death during the war,
and then proceed as follows), and who has since the said war died
(here state specifically the cause of the death of the husband of the
applicant and the date thereof) ; and that to the best of my knowledge,
during the said war my said husband was loyal and true to his duty,
and never, at any time, deserted his command or voluntarily abandoned
his post of duty in the said service, and that I was never divorced from
my said husband, and that I never voluntarily abandoned him during his
life, but remained his true, faithful, and lawful wife up to the date of
his death, and that I am now a widow and that I am now entitled to
receive, under the said act, the sum of ........ dollars annually. And
I do further swear that I do not hold any position or office, either
national, State, city, or county, which pays me in salary or fees two
hundred dollars per annum; nor have I an income from any other
employment or other source whatever which amounts to two hundred
dollars per annum; nor do I receive from any source whatever money
or other means of support amounting in value to the sum of two hun-
dred dollars per annum; nor do I own in my own right, nor does any
one hold in trust for my benefit or use estate or property, either real,
personal, or mixed, either in fee or for life, of the assessed value of
seven hundred and fifty dollars; nor do I receive any aid or pension
from any other State, or from the United States, or from any other
source, and that I am without means of support, direct or indirect;
and I do further swear that the answers given to the following ques-
tions are true:

First. What is your age?

Second. Where were you born?

Third. How long have you resided in Virginia?

Fourth. How long have you resided in the city or county of your
present residence.

Fifth. What is you husband’s full name?

Sixth. When and where were you married, and by whom?

Seventh. When and where, as near as you can state, did your husband
die, and from what cause?

Eighth. Have you been married since the death of your said husband ?

Ninth. Where and with whom do you now reside?

Tenth. What property—real, personal, or mixed—do you own?

Eleventh. What assistance do you receive, and what income have you
from any source?

Twelfth. If your husband died since the war, please state where he
died, and, if possible, the name and address of the attending physician ?

Thirteenth. Give the names and addresses, if possible, of two comrades
in arms of your deceased husband ?

Fourteenth. Give the names and addresses of two persons who are
familiar with the circumstances of your husband’s death.
Fifteenth. If your husband died since the war, please state whether
his death resulted from wounds received in the war or from disease.

Sixteenth. Give, as near as you can, the nature of the wound or thic
character of the disease from which your husband died.

Seventeenth. Give here any other information you may possess re-
lating to the service of your husband or of his death that will support
the justice of your claim for aid.

Eighteenth. Is there any camp of Confederate veterans in the city
or county of your residence?

Nineteenth. Is there any one living, the residence and address of
whom is known to you, either comrade or otherwise, who has knowledge
of your husband’s service and of the cause of his death? If so or not,
state.

Given under my hand this .......... day of ...........00. ,19..

The jurat of the applicant shall be in the same form as prescribed
for Form No. 1.

(A)

Affidavit of Resident Witnesses.
This affidavit shall be in the same form as prescribed for Form No. 1.
(B)
Affidavit of Comrades.

We, ..... cece eee eee and ....... ee eee ee eee , do solemnly swear
that we are residents of the .............. of ...... ee eee » in the
State of cwicssuseuswsemsws > and that .................... > whose

name is signed to the annexed application for aid under the act of
the general assembly of Virginia, approved (auditor will insert in the
printed form the date of the approval of this act), is personally well
known to us, and that we have known her for ...... years, and know
her to be the widow of ............. 0... e seen eee , who was a (state
here whether soldier, sailor, or marine) in the military or naval service
of Virginia, or of the Confederate States, and that we were (state here
whether soldiers, sailors or marines) in the said service during the said
war, and that we were, with the said ............. ..., Members of
(here state the command and the immediate superior officers thereof),
and that to our personal knowledge, on or about the .......... day
Of cssnsenswxnseraws , 186.., at (here state battle or combat where
killed or fatal wounds received), and that the said ................
during the said war (state here whether killed or died as the result
of wounds received, or surgical operation therefor, or if he died after
the war, strike out all relating to death during the war and proceed
as follows), on or about the ........ day Of osixianieseese , 186..,
the said ...........0604- died, and that the said ................
was a true and loyal soldier in the said service, and was faithful in the
discharge of his duty as a (state here whether soldier, sailor, or marine)
in the said service, and that we have no personal interest in the allow-
ance of the applicant’s claim.

the ..cceeeeeeeeeees Of ..cceeceee cee eee . State of Virginia, this
teens ‘veces. May Of co... ce cece eee ney 19
(C)
Affidavit of Witnesses, not Comrades, as to Wounds.

Wes eins ewiweiesee ONO, taesanewrawias » Of the as caicscwsewes
GE wii sa Rio nde » in the State of ................ , do solemnly
swear that we personally know and are well acquainted with ........
smeewany » whose name is signed to the annexed application, and who

is applying for aid under the act of the general assembly of Virginia,
approved (auditor will insert in printed form the date of the approval:
of this act), and that we have known the said applicant for
years, and that to our personal knowledge she is the widow of ........
Wee va wee wa KER , who was a loyal and true (state here whether soldier,
sailor, or marine) in the military or naval service of Virginia, or of
the Confederate States, in the war between the States, and that on

eee eee ee

or about the ......... we. Gay of ..........0 00, , 186.., at (here
state battle or combat where killed or fatal wound received), the said
Lec n eee e cence ees during the said war (state here whether killed

or died as the result of wounds received, or surgical operation therefor,
and if he died after the war, strike out all relating to death during

the war and proceed as follows), on or about the ............ day
0) » 18.., the said ...............04. died, and
that the said ................. and ............005. lived as hus-

band and wife up to the date of the death of the said.............4.. ;
and that we have no personal interest in the allowance of the applicant’s
claim.

Subscribed and sworn to before me, oo... 2c. eee eee eee eee , in and
for the .........00. Of wsmaresanews ex y this sissewewraeews day of
(D)

Certificate of Physician.
ly xwewseermeemieme , a practicing physician in the ............
Of ucmiasswnemiawiaws , in the State of Virginia, do certify that I am
personally acquainted with .............+-: , whose name is signed

to the annexed application for aid under the act of the general assembly
of Virginia, approved (auditor will insert in printed form the date of
approval of this act), and that I attended her husband, the said . veeee
ee , during his last illness, and that from my professional
knowledge of the cause of his death I verily believe that his death
resulted from (state here the cause of death), and that I have no per-
sonal interest in the allowance of the applicant’s claim.
Given under my hand this .......... day of ............ , 19...
Nore.—This certificate shall only be required ‘in cases. where the
liusband has died since the close of the war.

(E)

Certificate of Camp of Confederate Veterans.
Shall be the same as in Form No. 1.
(F)
Certificate of Ex-Confedcrate Soldier.
Shall be the same as in Form No. 1.

(G)
Certificate of Commissioner of Revenue.

Shall be the same as in Form No. 1.

That if any applicant is unable to write his or her name, it shall be
written by some one, who shall sign as a witness after the applicant has
made his or her mark, and in the case of any applicant who has not
resided in the city or county where he or she resides at the date of the
passage of this act the period of time required by this act to entitle him
or her to file his or her application before the court of the said city or
county, it shall be lawful for any such applicant to file his or her appli-
cation in the city or county of his or her former residence.

§7. That no application shall be allowed, nor shall any aid be given or
pension paid, in any case, to any soldier, sailor, or marine, or to the widow
of any soldier, sailor, or marine under the provisions of this act where
it shall appear that any such soldier, sailor, or marine deserted his
command, or voluntarily abandoned his post of duty, or the said service,
during the said war; nor shall any application be allowed, nor any aid
be given, nor any pension paid, to any widow of any soldier, sailor, or
marine aforesaid who shall have been married to any such soldier, sailor,
or marine after the first day of May, eighteen hundred and sixty-eight,
nor to any widow, -if she have a husband living at the time of filing
her application for a pension under this act, or who shall hereafter
marry; nor to any such widow who was or has been divorced from any
such soldier, sailor, or marine, being her husband; nor to any widow
who voluntarily abandoned, and without cause, any such soldier, sailor,
or marine, being her husband, and continued to live separately from
him up to the date of his death; nor to any such soldier, sailor, or
marine who served as a substitute for another, nor to the widow of such
substitute; nor to any person who served only in the militia of the State;
nor to any person who held property the assessed value of which was
as much as seven hundred and fifty dollars and who made a voluntary
conveyance of said property to his children or to any other person.

§14. That all soldiers, sailors, or marines, and the widows of any
such, whose applications have been heretofore allowed and whose names
have been enrolled as required by the act of the general assembly of Vir-
ginia, entitled “an act to give aid to soldiers, sailors, or marines of
Virginia maimed or disabled during the war between the States, and
to the widows of Virginia soldiers, sailors, or marines whose husbands
lost their lives in the said war in the military service,” approved March
fifth, eighteen hundred and eighty-eight, and by the act amendatory
thereof, approved March first, eighteen hundred and ninety-two, and
by all other general pension acts heretofore passed by the general as-
sembly of Virginia and approved, and by the authority and according
to the requirements of any special act of relief heretofore passed by the
general assembly of Virginia and duly approved, shall remain upon the
said pension roll until their names are removed therefrom for the causes
provided by this act. And that all others, except such as are referred
to in section fifteen, before they shall be entitled to any relief under the
provisions of this act, shall comply with the requirements thereof, and
no special act for the relief of any such soldiers, sailor, or marine, or
the widow of any such, shall hereafter be passed by the general assembly
of Virginia.

§15. That no soldier, sailor, or marine, nor the widow of any such,
whose application has been allowed, and whose name has been placed on
the pension rolls under the provisions of the act of the general assembly
approved March seventh, nineteen hundred, shall be entitled to receive
any aid under the provisions of this act until he or she shall have com-
plied with the requirements of this section, and the roll of claimants
under the said act of March seventh, nineteen hundred, shall have been ex-
amined, revised, and certified as hereinafter provided. That the auditor
of public accounts shall immediately, upon the approval of this act,
furnish to the clerk of the circuit court of each county, and to the clerk
of the corporation or hustings court of each city, a list of all appli-
cations filed and allowed under the provisions of said act of March
seventh, nineteen hundred, together with the original applications filed
in his office, for examination and revision in the manner hereinafter
provided. That upon the receipt of such certified list, with the accom-
panying applicants from the auditor of public accounts, as aforesaid,
the clerk of the circuit court of each county, and the clerk of the cor-
poration or hustings court of each city, shall immediately cause to be
made three certified copies of the said list, and shall post one copy thereof
at the front door of the courthouse of said county or city, and shall
deliver one copy thereof to the board of commissioners in this act pro-
vided for, and one copy thereof to the judge of the circuit court of such
county, or to the judge of the corporation or hustings court of such
‘city. That ten days after such list shall have been first posted at the
front door of the courthouse as aforesaid, the said board of commissioners
shall meet in the clerk’s office of such county or city and carefully ex-
amine the original applications for aid under the act of March seventh,
nineteen hundred, and shall make all inquiries and investigations
necessary to test the merits of any claim referred to in the list so certified
by the auditor of public accounts to the clerk of such court, and shall
revise and correct the said list accordingly, and make report of their
proceedings and actions in the premises to the court, or to the judge
thereof in vacation, and in their said report shall show the names of all
soldiers, sailors, and marines and the widows of any such so listed or
enrolled under the provisions of the act approved March seventh, nine-
teen hundred, who are by the provisions of this act entitled to receive
aid. When the report of the board of commissioners has been so made
up and filed, each applicant or pensioner under the provisions of the
act of March seventh, nineteen hundred, shall file before the court, or
the judge thereof in vacation, a sworn statement supported by the oath
of two witnesses of known good reputation, the certificate of the com-
missioner of the revenue in form and substance as required by section
four, and the certificate of some reputable practicing physician, and
thereupon the said court, or the judge in vacation, when satisfied from
the report of the said commissioners and the sworn statement of the
pensioner and the jurat, and certificate therewith filed, and as well
from an inspection of the original application, that such pensioner, under
the act approved March seventh, nineteen hundred, comes within and
is entitled to aid under the provisions of this act, shall order the clerk
of the said court to certify to the auditor of public accounts that the
applicant comes within the provisions of this act, and is entitled to the
relief therein provided.

That the statement of applicant or pensioner, the oath of the witnesses,
and the certificate of the physician shall be in form and _ substance
following:

Form of Statement.

diy eS he Boe 3 <Eer v on Bae os of the county of ...............04. > in the
State of Virginia, do solemnly swear that I am the identical person
named in the original application dated on the .............. day of
eee ree , 190.., and who filed the said application for aid under

the provisions of an act of the general assembly, approved March
seventh, nineteen hundred, for aid as a (state here whether soldier, sailor,
or marine, or the widow of a deceased soldier, sailor or marine) of Vir-
ginia, in the service of the said States, or of the Confederate States, during
the war between the States, and thatI am now an actual resident of the
county of .............. in the said State (if a widow, and that I am
a widow at the date of the filing of this statement), and that I do not
hold any national, State, city, or county office which pays me in salary
or fees two hundred dollars per annum; nor have I an income from any
other employment or other source whatever which amounts to two
hundred dollars per annum; nor do I receive from any source whatever
money or other means of support amounting in value to the sum of two
hundred dollars per annum; nor do I own in my own right, nor does
any one hold in trust for my benefit or use, nor does my wife own, nor
does any one hold in trust for the benefit of my wife, either real, personal,
or mixed property or estate, either in fee or for life, of the assessed value
of seven hundred and fifty dollars; nor do I receive any aid or pension
from any other State, or from the United States, or from any other source,
and that I am not an inmate of the soldiers’ home. And I do further
swear that I am disabled as follows (insert nature and character of
disability), and that my disability arose from (insert the cause of dis-
ability), and that I am now ................ years of age, and that
the statements contained in my original applications above referred to are
true, and that during the said war I was loyal and true to my duty as a
(state here whether soldier, sailor, or marine) of Virginia, or of the
Confederate States, and never, at any time, deserted my command or
voluntarily abandoned my post of duty in the said service. (In the case
of a widow, after the words soldiers’ home proceed as follows): That
Tam .......... years of age, and that I was married to my said
husband before the first day of May, eighteen hundred and sixty-eight,
and that I was never divorced from my said husband, and never
abandoned him, but was his true, faithful and loyal wife at the time of.
his death, and that my said husband (state whether he was killed during
the war or died after the war), and that his death resulted from (state
here the cause of your husband’s death), and that he (state here when
and where husband was killed or died), and that I have no means of
support, either direct or indirect, and that the statements contained in
my original application above referred to are true.

Subscribed and sworn to before me ............. -., and in for
the county of 2.0.0... ee eee eee eee , in the State of Virginia.

Jurat of Witnesses.

Wey saaseosoreaemeenes and ..... cee eee eee of the county of
TT , in the State of Virginia, do solemnly swear that we
are personally acquainted with ...........0---+++6: , whose name is
signed to the annexed jurat, and that the said ..............-.+. is

still living, and that we verily believe the statements contained in the
annexed affidavit to be true. .

Subscribed and sworn to before me, ...... eee eee eee in and for
HNO: . on ea ti awewenwaR 0) a , and I do certify that the
said ccc ee eee eee and ascesenemiae , whose names are signed to the

annexed jurat, are persons of well-known reputation for truth, honesty
and integrity, and residing in the said ...........-.5+-

Cerlificale of Physicians as to Soldiers, Rlectera,

| , a practicing physician in the ............
OF sseigewosns exe , in the State of Virginia, do certify that 1 am
personally acquainted with ...........-...++- , whose name is signed

to the foregoing statement, and who made application for aid under the
act of the general assembly, approved March seventh, nineteen hundred,
and that from a personal examination of the said ............++.. as
to the disability set forth in his application and the cause thereof IT am
clearly of the opinion that he is disabled by reason of (here state spe-
cifically the nature of the disability and the cause thereof, and whether
it be total or partial, and whether the applicant is deprived of ability
to pursue his usual and ordinary occupation for his livelihood, or any
other occupation within his capacity), and that I verily believe his
disability is wholly due to the causes assigned in the said application,
and that he is entitled to aid under the provisions of the act of the
general assembly of Virginia, approved (the auditor mall insert the date
of the approval of this act).

Given under my hand this ............ day of ............ ,19..

And that in the case of a widow’s claim so atlowed under the said act
of March seventh, nineteen hundred, whose husband died after the said
war, she shall furnish the certificate of the physician who attended her
husband in his last illness, if such physician be living and his address
be known to her, and if not, then she must file with her statement, as
hereinafter required, the affidavit of one or more reputable persons who
are familiar with the circumstances of her husband’s death. The form
of the certificate of the physician shall be to the following effect:

Certificate of Physician as to Claim of Widow.

| , a practicing physician in the ................
0) in the State of Virginia, do certify that I am
personally acquainted with ................-.005- » whose name is

signed to the foregoing statement, and who made application for aid
under the act of the general assembly, approved March seventh, nine-
teen hundred, and that I attended her husband, the said ............
during his last illness, and that I verily believe his death resulted from
(state here the cause of death).

Given under my hand this ............ day of ............ , 190..

ec

816. That after an application has been once so passed, approved
and allowed, it shall only be necessary for the applicant annually there-
after, between the first day of April and the first day of August, to
file with the auditor of public accounts an affidavit of the applicant,
made before some officer in this State authorized by its laws to ad-
minister an oath, and the certificate of the commissioner of the revenue
as required in form number one. The affidavit of the applicant and the
certificates of such officers thereto, shall be in the form and substance
following, to-wit:

T, wc... eee eee , of the county 0) , in the State of
Virginia, do solemnly swear that I am the identical person named in
the or iginal or subsequent application with disabilities therein rated
fled in .............0000- county, for aid as a (soldier, sailor or
marine) or (widow of a deceased soldier, sailor or marine), of Virginia,
in the service of the said State, or of the Confederate States, during
the war between the States, and ‘that T am now an actual resident of the
county Of .. 6... cece eee eee , in the said State (if a widow, and that I
am a widow at the date of the filing of this certificate), and that I do
not hold any national, State, city or county office which pays me in
salary or fees two hundred dollars per annum; nor do I receive from
any source whatever money or other means of support amounting in
value to the sum of two hundred dollars, nor do I own in my own right
nor does any one hold in trust for my benefit or use, nor does my wife
own nor does any one hold in trust for her benefit, either real, personal
or mixed property or estate, either in fee or for life, of the assessed
value of seven hundred and fifty dollars, nor do I receive any aid or
pension from any other State, or from the United States, or from
any other source, and that I am not an inmate of a soldiers’ home, and
that I am without any means of support, either direct or indirect.

Subscribed and sworn to before me ............ » in and for the
county of ................ > this caseaens as day of ......... , hine-
teen hundred and ............

And it shall be the duty of the auditor of public accounts, on or before
the first day of March in each year, to mail to each pensioner, upon the
said pension roll, the forms prescribed in this section, with instructions
how the same shall be executed and returned to this office, and he shall
not pay to any pensioner upon the said roll the amount allowed him
under the provisions of this act until the provisions of this section
have been complied with.

Whenever it shall appear that the original application for a pension
or the jurats thereon for any year has been lost or destroyed, or if, from
any cause the pension list or the name of any pensioner thereon for any
year for any cause has not been certified to the auditor of public accounts
for payment, it shall be lawful for such pensioner or pensioners to make
out new application for such year and have the same certified as pro-
vided in this act, and the auditor of public accounts shall pay such
pensioner or pensioners as if they were made out on original appli-
cation, out of any money in the treasury not otherwise appropriated.

And the auditor shall strike from the pension roll the names of all
pensioners whose income exceeds, in assessed value, seven hundred and
fifty dollars, as hereinbefore provided.

It shall further be the duty of the auditor of public accounts to
answer promptly in writing all inquiries by mail made of him by any
resident of Virginia relative to pension matters in this State, and to
furnish all information requested relative to the application for, refusal
or allowance of any pension under this act.

§18. That for the proper discharge of his duties under this act the
auditor of public accounts shall employ, and fix the compensation of
such clerical help as he may need to carry out the provisions of this act.
The cost of such clerical help and the expense of printing, postage,
books, and advertisement provided by this act, shall be paid out of the
sum of money heretofore appropriated, not to exceed, however, the sum
of six thousand five hundred dollars annually.

§20. That the sum of four hundred and twenty-five thousand dollars
or so much thereof as may he necessary be, and is hereby appropriated
for the fiscal year ending February twenty-eighth, nineteen hundred and
nine, and for each year thereafter, to meet the requirements of this act,
payable out of any money in the treasury, not otherwise appropriated.
The pensions of all persons on the pension roll at the time of the ap-
proval of this act shall be increased according to the amounts specified
in ce act in the respective classes in which the said pensioners are now
rated.

An emergency existing in the needs of the proposed beneficiaries of
this act, this act shall be in force from its passage.