Chap. 453.—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, sail-
ors, 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, and providing pen-
alties for violating the provisions of this act.

Approved April 2, 1902.

1. Be it enacted by the general assembly of Virginia, That there shall
be paid out of the treasury of Virginia, upon the warrants of the auditor
of public accounts, annually, on or before the first day of May, in each
year, the amounts hereinafter specified to the persons hereinafter desig-
nated, described and classified, who, at the time application is made for
aid under this act, shall be citizens and bona fide residents of Virginia,
and shall have actually resided in this State for two years, and in the
county or city from which such application is certified for one year, and
who shall make application for such aid, and furnish the proofs and
comply with the other requirements of this act, as hereinafter specified
and required—to-wit:

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
‘yperation therefor, while in the discharge of his duty as a soldier, sailor,
or marine of Virginia in the war between the States, the sum of one
hundred 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 fifty dollars per annum.

Class C.—To every person who is disabled by wounds received, or sur-
gical 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 proven to be total, the sum of thirty dollars per an-
num, and if such disability be proved to be partial, the sum of fifteen
dollars per annum.

Class D.—To every person over the age of sixty-five vcars who was
loyal and true as a soldier, sailor, or marine of Virginia during the said
war, and who by reason of the infirmities of age has become disabled and
incapable of earning a livelihood, if such disability be proven to be total,
the sum of thirty dollars per annum, and if such disability be proven to
be partial, the sum of fifteen dollars per annum.

Class E.—To every widow, remaining unmarried, of any soldicr, 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, 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, the said widow hav-
ing remained unmarried to the time of her application for aid, the sum
of twenty-five dollars per annum.
2. This act shall apply to every native of Virginia, and to the widows
of such as are dead, as hereinbefore classified, who enlisted from this or
any other State in the military or naval 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 here-
inbefore provided; but no person holding a national, State, city, or
county office which pays in salary or fees one hundred and fifty dollars
per annum, or whose income from any employment or source whatever
is one hundred and fifty dollars per annum, or who receives from any
source whatever money or other means of support amounting in value to
one hundred and fifty dollars per annum, or who owns in his or her
own right, or where there is held in trust for his or her benefit, or whose
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
five hundred dollars, or who is in receipt of aid or of a pension from any
other State, or from the United States, or from any other source, or who
is an inmate of any soldiers’ home, or other public institution, shall be
entitled to the benefits of this act.

3. Before any person shall be entitled to the benefits of this act, or re-
ceive the aid hereby provided for, he or she shall file in the clerk’s office
of the circuit court of the county, or in the clerk’s office of the corporation
or hustings court of the city wherein he or she may reside, at least twenty
days before any regular term of the said court, an application for relief
under this act, subscribed and sworn to by such applicant before some
officer authorized by the laws of Virginia to administer an oath, sup-
ported and accompanied by the affidavits of at least two disinterested
and reputable witnesses, residents of the city or county wherein the said
applicant resides, and to whom the said applicant is personally well
known, as to the character and reputation of the said applicant for truth
and honesty, and as to the nature of the disability; also by the affidavits
of at least two of the comrades in arms of the applicant, or of the de-
ceased soldier, sailor, or marine, if two such be living, and if not, then
one of such comrades, if one be living, and if no such comrade be living,
the residence and address of whom is known to the applicant, then of one
or more reputable persons who have personal knowledge of the service of
any such soldier, sailor, or marine, and of the cause of disability or death,
as the case may be, if any such person or persons be living, the resi-
dence and address of whom is known to the applicant; and if there be no
such comrade or comrades, person or persons living, the residence and
address of whom is known to the applicant, this fact must be specifically
set forth in the application; also the certificate of some reputable and
practicing physician as to the nature and character of the disability and
the cause thereof; and in the case of a widow’s application, the certificate
of the attending physician at the time of the death of her husband as
to his death, if such physician be living, and the residence and address
of whom is known to the applicant, and if such physician be dead, or his
residence and address unknown to the applicant, this fact must also
specifically appear in the application, also the certificate of some camp of
Confederate veterans of the city or county wherein the applicant resides,
and if there be no such camp in said city or county, then the certificate of
two ex-Confederate soldiers well known and of good reputation residing
in said city or county; that,after examination into the merits of the appli-
cation, the said camp, or the said ex-Confederate soldiers, are satified as
to the truth of the statements therein contained, and that the applicant
is entitled to relief under this act, and if there be no such camp in the
city or county where the applicant resides, this fact must also specifically
appear in the application; and also the certificate of the commissioner
of the revenue of the city or county wherein the applicant resides show-
ing with what real, personal, or mixed estate or property the applicant,
or his wife, or his or her trustees, or the trustee of the applicant’s wife,
is assessed and the assessed value thereof.

4. That the said applications, affidavits, and certificates shall be in
form and substance as follows:

Form No. 1.

APPLICATION OF SOLDIER, SAILOR, OR MARINE FOR DISABILITY BY

WounpD.

| ra , 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 resi-
dent at... ... ccc ccc cece ec cenees > im the... ... ccc eee cece eee eeee of
La eee eee cere cece sees , in the said State, and that I have been an
actual resident of the said State for two years, and of the said (city or
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 Virginia in the war between the United States and the Confederate
States, and that while in the discharge of my duty in the service of the
Confederate 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..........
day of............045. , 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
follows: (here state specifically the character of the wound and the dis-
ability occasioned thereby, and whether such disability is total or par-
tial) ; 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 na-
tional, State, city, or county office which pays me in salary or fees one
hundred and fifty dollars per annum; nor have I an income from any
other employment or other source whatever which amounts to one hun-
dred and fifty dollars per annum; nor do I receive from any source
whatever money or other means of support amounting in value to the
sum of one hundred and fifty dollars per annum; nor do | own in my
own right, nor does any one hold in trust for my benefit or use, nor
dees 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 five hundred dollars; nor do I receive any aid or pen-
sion 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, or of any
other public institution, and I do further swear that the answers given to
the following questions are true: |

1. What is your age?

2. Where were you horn?

3. How long have you resided in Virginia?

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

5. What is your usual and ordinary occupation for earning a liveli-
hood ?

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

%. 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.

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

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

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

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

12. How long were you in the service?

13. In what battle or combat were you wounded, and under what cir-
cumstances were you wounded ?

14. 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 ?

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

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

1%. If sight or limb was not lost, what is the precise nature of your
disability caused by any wound or wounds reccived in said service, and
in what way are you disabled by it? .

18. 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.

19. 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.
20. Is there any camp of Confederate veterans in the city or county of
your residence ?

21. 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.

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

Witness my hand this...... day of..........ee eee , 19...

eee4nHveececse#eeve#eese+eeveesde8ekereeeseeewn#etre

| fr rn in and for the...........
0) , In the State of Virginia, do certify that
Lecce cece eee ee eee , whose name is signed to the foregoing applica-
tion, 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............e000:
made oath before me that the said statements and answers are true.

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

(A)

OAT OF RESIDENT WITNESSES.

the said State, and that we have known personally and well for.......
YOATS.. cece cece cece eee , whose name is signed to the annexed appli-
cation for aid under the act of the general assembly of Virginia, ap-
proved (auditor will insert in printed form the date of the approval of
this act), and that the said................... 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 ques-
tions therein propounded made by the said applicant, and verily believe
that the said applicant has been truthful in the said statements and an-
swers, 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 un-
der 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..............2 0000. for the
TTT Tre Of .......eeeeeeeee--, State of Virginia, this......day
the State of......... 0. cee , and that...........cceeeees » 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 the State of Virginia, or of the Confederate States,
during the war between the United States and the Confederate States,
and that the said..............00e0e- , 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...........000.- , 186..
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, and
that we have no personal interest in the allowance of the applicant’s
claim.

Subscribed and sworn to before me, a................- :.for the
se eeeee eee Of... cee eee ee eee eee, state of Virginia, this........
day of..............000. ,19..

(C)
AFFIDAVIT OF WITNESSES, NoT COMRADES, AS TO WOUNDS.

We, ..ccc cece cc ccccecees 6 , do solemnly
swear that we are residents of the........ 0) , in
the State of...............0.- , and that we personally know and are
well acquainted with................206- , 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........ vears, and that to our personal
knowledge the said...............-2000- 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
0) re , 186.., at (here state the battle or combat where
the wound was received, the nature of the wound, and the disability oc-
casioned thereby), and that we have no personal interest in the allowance
of the applicant’s claim.

Subscribed and sworn to before me, a..........0e ee ee evens in and
for the............. 6) , State of Virginia, this
wee eee day of................00, 19

(D)
CERTIFICATE OF PHYSICIAN.

dg dmwesmurdes stdin inne , a practicing physician in the.......... of
ee rrTTe rT eT errre , in the State of Virginia, do certify that I am per-
sonally acquainted with..............006- , 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............ , as to the disability sect forth in his application and
the cause thereof, I] am clearly of the opinion that he is disabled by reason
of (here state specifically the nature of the disability and the cause
thereof, and if such disability be total, whether the applicant is deprived
thereby of all ability to pursue his usual and ordinary occupation for a
livelihood, or any other occupation for a livelihood, and if the disability
be partial, to what extent the applicant is hindered thereby from pur-
suing such occupation as aforesaid), and that I verily believe his disa-
bility 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............... ,19..

(E)
CERTIFICATE OF CAMP OF CONFEDERATE VETERANS.

The... . cece eee eee ee camp of Confederate veterans of the........
0 , 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
0 Oa for aid under the provisions of the said act, and
that it has no personal interest in the allowance of the applicant’s claim.

Commander.
(F)

CERTIFICATE OF EX-CONFEDERATE SOLDIERS.

We, ... ccc cece cece eeees ANd... cee ee eee ee eee , of the........
0) re , State of Virginia, do certify that we were (sol-
diers, sailors, or marines) of Virginia in the war between the States, and
that we have examined into the merits of the annexed application of
cece cere 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 provisions
of the said act, and that we have no personal interest in the allowance of
the applicant’s claim.

Given under our hands this........ day of............006. ,19..
(G)
CERTIFICATE OF TIE COMMISSIONER OF THE REVENUE.
| , commissioner of the revenue in the.........
0) , in the State of Virginia, do certify that......
sec ceeeese 66.., or his wife, or his trustee, or trustee for his wife, 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 appraval of this act), is charged on the land and

personal property books of the said............. with estate, real, per-
sonal, and mixed, of the assessed value of........... dollars.
Given under my hand this........ day of..............., 19..
Form No. 2.

APPLICATION FOR DISABILITY BY REASON OF DISEASE OR THE INFIRMI
TIES OF AGE.

Dy seb ateeeeeaeeseaes , do hereby apply 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 solemnly
swear that I am a citizen of the State of Virginia, resident at..........
in the............ 0 , in the said State, and that
I have been an actual resident of the said State for two years, and of the
C0 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 Virginia in the war between the United States and the Con-
federate States as a member of (here state specifically the command and
branch of service to which the applicant belonged, and the names of his
immediate superior officers, and in the case of disability caused by dis-
ease, then proceed as follows), and that I am now disabled by disease
(here state specifically the nature of the disease and the causes from
which it resulted), and that from the effects of such disease I am now
permanently disabled from following my usual and ordinary occupation,
or any other occupation, for a livelihood (and in the case of disability
from the infirmities of age, strike out all relating to disability by disease,
and then proceed as follows) ; and that I am now suffering from the in-
firmities of age, and permanently incapacitated thereby from following
my usual and ordinary occupation, or any other occupation, for a liveli-
hood (here state specifically the nature and character of the disability
which prevents the applicant from following any occupation for a liveli-
hood), 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.......... dol-
lars annually. And I do further swear that I do not hold any national,
State, city, or county office which pays me in salary or fee one hundred
and fifty dollars per annum; nor have I an income from any other em-
ployment, or any source whatever, which amounts to one hundred and
fifty dollars per annum ; nor do I receive from any source whatever money
or other means of support in value of the sum of one hundred and fifty
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, personal, or
mixed, either in fee or for life, of the assessed value of five hundred dol-
lars; 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 or any other public institution; and I do further
swear that the answers given to the following questions are true:

1. What is your age?

2. Where were you born?

3. How long have you resided in Virginia?

4. How long have you resided in the city or county of your presen
residence?

5. What is your usual and ordinary occupation for earning a liveli-
hood ?

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

%. 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?

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

9. What were the causes which led to the disease which has resulted in
your disability ?
10. How long have you suffered from such disease, and when did you
first become aware that you were afflicted with the same?

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

12. Are you totally disabled because of such disease, or the infirmities
of age, from following your usual and ordinary occupation or employ-
ment, or any other occupation or employment, by which to earn a liveli-
hood? If not totally disabled thereby, but only partially, state the extent
of your partial disability.

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

14. In what command and service .were you engaged during the war
between the States?

15. How long were you in the service ?

16. When did you leave the service, and under what circumstances ?

1%. If suffering from disease, state what physician or physicians have
attended you for the same.

18. 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.

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

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

21. 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 so or not, state.

Witness my hand this........ day of.............0.. 19..

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

(A)
OaTH OF RESIDENT WITNESSES.
This affidavit shall be in the same form as prescribed for Form No. 1.
(B)

AFFIDAVIT OF COMRADES.

a 6 , do solemnly
swear that we are residents of the............ of...... Let eeeeee , in
the State of.............005065- , 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 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
31
naval service of Virginia, or of the Confederate States, during the war be-
tween 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, members of (here state
command and immediate superior officers thereof), and that the said
eee eee eee eeees was a loyal and true (state here whether soldier,
sailor, or marine) in the 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.

Subscribed and sworn to before me, ............00 eee eees , of the
eee yee aes Of...................., state of Virginia, this........

(C)

AFFIDAVIT OF WITNESSES, NOT COMRADES, AS TO THE SERVICE AND Dis-
ABILITY OF THE APPLICANT.

We, ... cece eee cece eee ees ANd... eee eee ee ees , do solemnly
swear that we are residents of the.......... 0) , in
the State of.................. , 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 knowledge
the said applicant was a loyal and true (state here whcther soldier, sailor,
or marine) in the military or naval service of Virginia, or of the Confed-
erate States, in the war between the States, and was faithful in the dis-
charge 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 allowance of his
claim under the said act.

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

(E)

CERTIFICATE OF CAMP OF CONFEDERATE VETERANS.

fal,
e

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

(F)
CERTIFICATE OF EX-CONFEDERATE SOLDIERS.

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

(G)
CERTIFICATE OF COMMISSIONER OF THE REVENUE.

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

Form No. 3.
APPLICATION OF WIDOW.

PET rerrrerraverrerreers , do hereby apply 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 solemnly
swear that I am a citizen of the State of Virginia, and resident at......
wee eceees 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. .......... eee for one year, next preceding the date of this ap-
plication, and that I am the widow of................004. , who was
a (state here whether soldicr, 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 husband of the applicant belonged, and, if possible, 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 law-
ful wife up to the date of his death, and that I have never married since
his death, 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 one hundred and fifty dollars per annum ;
nor have I an income from any other employment or other source what-
ever which amounts to one hundred and fifty dollars per annum; nor do
I receive from any source whatever money or other means of support
amounting in value to the sum of one hundred and fifty dollars per an-
num ; nor do I own in my own right, nor docs 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 five hundred 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
public institution, and that I am without means of support, direct or in-
direct; and I do further swear that the answers given to the following
questions are true:

1. What is your age?

2. Where were you born?

3. How long have you resided in Virginia ?

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

5. What is your husband’s full name?

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

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

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

9. Where and with whom do you now reside?

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

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

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

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

14. Give the names and addresses of two persons who are familiar with
the circumstances of your husband’s death.

15. If your husband died since the war, please state whether his death
resulted from wounds received in the war or from disease.

16. Give, as near as vou can, the nature of the wound or the character
of the disease from which your husband died.

1%. Give here any other information you may possess relating to the
service of your husband or of his death that will support the justice of
your claim for aid.

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

19. 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............... ,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, ccusecaswsnsasaewens 6 Oe , do solemnly
swear that we are residents of the.......... Op oa cgaeheew seer eae , in
the State of............0ee00. , 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 he the
widow Of.........e eee weeeee , 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..........-...000- , members of (here state the command
and the immediate superior officers thereof), and that to our personal
knowledge, on or about the......... day of..............00. , 186..,
at (here state battle or combat where killed or fatal wounds reccived),
and that the said........... cece eens during the said war (state here
whether killed or died as the result of wounds received, or surgical opera-
tion 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
acne eee ee eee eeens , 186.., the said....................died, and
that the said.............2-+e08- 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 allowance of the applicant’s claim.

Subscribed and sworn to before me, .............ccceeeees » for the
(C)

We, on... cccccccccccces ONG... cece eee eee , of the..........

0) , in the State of................6. , do solemnly
swear that we personally know and are well acquainted with...........
ceasceeans » whose name is signed to the annexed application, and who is

applying for aid under the act of the general assembly of Virginia, ap-
proved (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...............

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 or about the........ day of
beeen erence wees , 186.., at (here state battle or combat where killed
or fatal wound received), the said................008. 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
eamnedeas day of................,18.., the said..................
died, and that the said.................6.. 06 Or
lived as husband and wife up to the date of the death of the said.......
eee e cece wees , and that we have no personal interest in the allow-
ance of the applicant’s claim.

Subscribed and sworn to before me, ................ in and for the
Dene e eee Of.............--.60, this........day of........... 205;
19...

(D)
CERTIFICATE OF PHYSICIAN.

| a , & practicing physician in the.......... of
pongo ease ee eases , in the State of Virginia, do certify that I am per-
sonally acquainted with............0.e00.. , 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 ap-
proval of this act), and that I attended her husband, the said.........
errr trrr rr , during his last illness, and that from my professional
knowledge of the cause of his death I verily believe that his death re-
sulted from (state here the cause of death), and that I have no personal
interest in the allowance of the applicant’s claim.

‘Given under my hand this...... day of..... see e eee ,19..

e@oe5s5e#ee#2e#e#e8e#ee¢e¢#20ee8kf eee cemUmhmUOMmUCUCOOmUCUC OrmhUCUc OrmMUCUcCOmhUCUhhUMOmCUCUCOUCUh Hh

NotE.—This certificate shall only be required in cases where the hus-
band has died since the close of the war.

(B)
CERTIFICATE OF CAMP OF CONFEDERATE VETERANS

Shall be the same as in Form No. 1.

(F)
CERTIFICATE OF EX-CONFEDERATE 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 re-
sided 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 applica-
tion in the city or county of his or her former residence.

5. That the auditor of public accounts may, and it shall be his duty,
to prescribe such further forms, and to add to the forms hereby provided
such further requirements and such further questions as he may deem
necessary to fully test and establish the merit and justice of the claims
under this act, and he shall formulate such rules, regulations, and in-
structions as he may deem proper for the preparation, filing, execution,
and certifying of all applications, and the documentary proofs in support
thereof, and shall cause all such forms as are hercinbefore required, or
may hereinafter be required, and such as he may prescribe, together with
such rules, regulations, and instructions, to be printed, and shall cause a
sufficient number of the forms of cach class, together with the rules, reg-
ulations, and instructions aforesaid, to be distributed and furnished to
the clerk of each of the courts hereinbefore mentioned.

6. That total disability within the meaning of this act shall be proved
to be such as wholly incapacitates the applicant for following his usual
and ordinary occupation, or any other occupation, for a livelihood, and
partial disability, within the meaning of this act, shall be proved to be
such as seriously and materially impairs the capacity of the applicant for
following his usual and ordinary occupation, or any other occupation, for
a livelihood.

%. 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-six; nor
to any such widow who, since the death of any such soldier, sailor, or
marine, being her husband, has again married, 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.

8. That the clerks of each of the courts hereinbefore mentioned shall
endorse upon each application filed in his office the date of filing, and
shall, at least fifteen days before any regular term of the court, prepare a
list, alphabetically arranged, of all applications filed in his office twenty
days before any regular term of the court, which list shall set forth the
full name of the applicant, and whether the claim be of a soldier, sailor,
or marine or widow, the cause of disability or of death, the date of death,
and the name of the command of the soldier, sailor, or marine, or of
the deceased, and said clerk shall make three certified copies thereof, and
shall deliver one copy thereof to the chairman of the board of commis-
sioners hereinafter provided for, and post one copy thereof at the front
door of the courthouse of the city or county, and, on the first day of
the next regular term of the court, shall deliver one copy thereof to the
court, together with the applications therein listed.

9. That the circuit court of each county, and the corporation or
hustings court of each city, shall, at each regular term of the court, take
up, examine, and consider all applications certificd by the clerk thereof,
as aforesaid, and if such court shall be satisfied that the requirements of
this act have been substantially complied with, and that the application
ig supported by the affidavits and certificates herein required, or by oral
testimony in open court (ifthe court shall require oral testimony) of
persons of well-known reputation for truth, honesty, and integrity, and
satisfied as well of the justice of the claim of the said applicant; if there
be no objections filed or offered by the board of commissioners hereinafter
named, or by any other person, to the said application being certified,
shall endorse on the back of each application a certificate or order to the
following effect:
The circuit court of the county or the corporation or hustings court of
the city of.............4. (as the case may be), from an examination of
the within application of.............. , and of the affidavits and cer-
tificates therewith filed, and hereto annexed, and of such witnesses as
were required and called by the court, being satisfied that the said appli-
cation is supported by the affidavits and certificates, and oral testimony
(if any oral testimony is required by the court) of persons of well-known
reputation for truth, honesty, and integrity, and that the claim of the
said applicant is-just, and in due form, and doth certify the same to the
auditor of public accounts.

In case there shall be filed or offered by the said board of coiunmission-
ers, or any other person, objections to the certifying of any,such applica-
tion, the court shall cause the applicant and such other persons as it may
deem necessary, or which either party may require, to appear before the
court at such time as the court may fix, and after a full hearing shall de-
termine the case according to its merits and justice, and if such applica-
tion shall be disallowed, shall endorse, or cause to be endorsed, upon the
application the reasons for disallowing the same. And the clerk of the
said court shall enter upon the minute book of the court an order show-
ing all applications allowed or disallowed, and shall certify a copy of
the said order, under the seal of the court, to the auditor of public ac-
counts, and forward the same to the said auditor, with all applications
either allowed or disallowed, at any regular term of the court.

10. That the auditor of public accounts shall carefully examine such
applications, and the affidavits and certificates thercto, upon receipt
thereof. And upon being satisfied that all the requirements of this act
have been complied with in all particulars, and that the applicant is en-
titled to the aid as herein provided, he shall draw his warrant upon the
treasurer in favor of the applicant for the amount authorized by this act
to be paid him or her for the current year, within which such application
shall be finally approved by the auditor, and annually thereafter so long
as the said applicant shall remain upon the pension roll hereinafter re-
quired to be kept. The said auditor shall reject all applications in which
the proofs and facts certified do not show the applicant entitled to the
benefits of this act: provided, however, that before the auditor of public
accounts shall place any new applicant under this act upon the pension
roll, or pay any portion to any such new applicant, he shall, if obtain-
able, secure from the war department or pension office of the United
States the record of such applicant or deceased soldier, as shown by the
military records and rolls of the Confederate States, or of the State of
Virginia, and if the record of such applicant or deceased soldier, sailor,
or marine shall be not good, he may, after proper investigation as to such
record, reject such application.

11. The auditor of public accounts shall keep in his office a roll, to be
known as the pension roll of Virginia, in a book to be provided by him
for the purpose, in which the names of all applicants whose applications
have been finally approved by him shall be entered, the applicants to be
yrouped together in the counties or cities of their residence at the date
such application is allowed, the names of the applicants and of the cities
and countics to be alphabetically arranged, and the applicants from each
city or county to be entered in the classes as by this act provided; and
which roll shall also show the residence and postoffice address, his or her
age, the disability of the applicant, and the date the application is al-
lowed. The auditor shall also keep, in a book provided for the purpose,
a record of all applications disallowed, arranged alphabetically, accord-
ing to cities and counties, and the names of the applicants, and the said
records shall show the reasons for the disallowance of the application.
And the auditor shall annually, on or before February first in each year,
certify to the clerk of the circuit court of each county, and to the corpora-
tion or hustings court of each city, a copy of the roll of the pensioners for
any such city or county, whose claims have been allowed, for examination
and revision # hereinafter provided, and he shall cause to be crased from
said pension roll the names of all applicants who shall be certified under
the provisions of this act as having died, or as being improperly placed
thereon.

12. That there shall be appointed by the circuit court of each county,
and by the corporation or hustings court of each city, or by the judge
thereof in vacation, immediately after the approval of this act, and in
the month of January in each year thereafter, a board of three commis-
sioners, residents of such county or city, none of whom shall be either
State, city, or county officers, and any two of whom may act, and two of
whom shall be ex-Confederate soldiers, and all of whom shall be free-
holders and persons of good reputation, who are to serve without compen-
sation, and to constitute a board, whose duty it shall be to examine into
the merits of the applications, a list of which shall have been furnished
them by the clerk of the said court, as hereinbefore provided, and who
shall, if there be any just cause against the allowance of any claim, on
the first day of the next succeeding regular term of any such court, make
a report in writing to the said court, setting forth the objections to the
allowance of any claim so referred to them, and furnish to the said court
such information or testimony as they may have in support of any such
objection, and whose duty it shall be also, on or before the fifteenth day
of February in each year, to meet in the clerk’s office of such court, and
examine the pension roll certified to the clerk by the auditor of public
accounts, under the provisions of this act, and report, in writing, to the
said court, or the judge thereof in vacation, the names of such pensioners
as have died during the preceding year, as also the names of such pen-
sioners as should be dropped from the said rol] because improperly placed
thereon, and the reasons why such pensioners should be so dropped and
the evidence in support of the same. And the said court, or the judge
thereof in vacation, shall forthwith cause, by rule or other process, any
pensioner who is so reported to be improperly placed upon the pension
roll to appear before the said court, or the judge thereof in vacation, to
show cause why his or her name should not be stricken off, and further
aid to him or her discontinued, under the provisions of this act, and if,
after a full hearing, the said court or the judge thereof be satisfied that
the said applicant is improperly on the pension roll, shall certify that
fact to the auditor of public accounts, and shall also certify a list of those
who have been reported as having died during the preceding year. Any
pensioner whose name shall be so dropped from the pension roll may ap-
ply to be restored to said roll, as hereinbefore provided in the case of an
original application. ‘The said board of commissioners shall organize
immediately after their appointment by the electian of one of their num-
ber as chairman, who shall preside over the meetings of the board, and
perform such other duties as the board may prescribe; and the members
of said board are hereby authorized and empowered to administer any
oath required under this act. :

13. Any affidavit required to be made under the provisions of this act
may be made before any officer of this State authorized by its laws to
administer an oath, and if made beyond the limits of this State, the
official character of the officer before whom such affidavit is so made shall
be certified by the clerk of some court of record, and that the said officer
before whom such affidavit was so made is authorized under the laws of
the State to administer an oath.

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 Virginia,
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 the authority and
according to the requirements of any special act of relief heretofore
passsed by the general assembly of Virginia and duly approved, shall re-
main upon the said pension roll until their names are removed there-
from 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 require
ments thereof. And no special act for the relief of any such soldier,
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
examined, revised, and certified as hereinafter provided. That the audi-
tor 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 applications
filed and allowed under the provisions of said act of March seventh, nine-
teen 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 accompanying applica-
tions from the auditor of public accounts as aforesaid, the clerk of the
circuit court of each county, and the clerk of the corporation 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 provided 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 examine the original applica-
tions 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, nineteen hundred, who are by the provisions
of this act entitled to receive aid. When the report of the board of com-
missioners 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 reputa-
tion, the certificate of the commissioner of the revenue in form and sub-
stance as required by section four, and the certificate of some reputable
practicing physician, and thereupon the said court, or the judge in va-
cation, 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 hun-
dred, 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 wit-
nesses, and the certificate of the physician shall be in form and substance
following:

Form oF STATEMENT.

[Ly vam swam nda amen ee ene , of the county of................008,
the State of Virginia, do solemnly swear that I am the identical oereOm
named in the original application dated on the...... day of...........

19.., and who filed the said application for aid under ‘the provisions of
an act of the general assembly, approved March seventh, nineteen hun-
dred, for aid as a (state here whether soldier, sailor, or marine, or the
widow of a deceased soldier, sailor, or marine) of Virginia, in the ser-
vice of the said States, or of the Confederate States, during the war be-
tween the States, and that I am now an actual resident of the county
OE. cascanesums , in the said State (if a widow, and that I have not mar-
ried since the date of the filing of my said application), and that I do
not hold any national, State, city, or county office which pays me in sal-
ary or fees one hundred and fifty dollars per annum; nor have I an in-
come from any other employment or other source whatever which
amounts to one hundred and fifty dollars per annum; nor do I receive
from any source whatever money or other means of support amounting
in value to the sum of one hundred and fifty 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 five hundred dollars; nor do I re-
ceive 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 or other public institution. And I do further swear that I am dis-
abled as follows (insert nature and character of disability), and that my
disability arose from (insert the cause of disability), and that I am now
ete e eee 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 public in-
stitutions proceed as follows): That I am...... years of age, and that
I was marricd to my said husband before the first day of May, eighteen
hundred and sixty-five, and that I have not married since his death, 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 ap-
plication above referred to are true.

Subscribed and sworn to before me, ..............2 eee e eee , in and
for the county of.............0008: , in the State of Virginia.

JURAT OF WITNESSES.

We, wn. ccc cc eccescescees 06 , of the county
0) , in the State of Virginia, do solemnly swear
that we are personally acquainted with................. , 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, ...........cccceeeeces , in and
for the............ 0) , and I do certify that the
BAId. .. ce cee eee ee ANd... eee cee wee eens , whose names are

signed to the annexcd jurat, are persons of well-known reputation for
truth, honesty, and integrity, and residing in the said............

CERTIFICATE OF PILYSICIAN AS TO SOLDIERS, ETC.

| » & practicing physician in the........... of
cece een eee ee eens , In the State of Virginia, do certify that I am per-
sonally acquainted with...............00- , 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 I 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 will insert the date of the approval
of this act).

Given under my hand this...... day of..............6. ,19..

And that in the case of a widow’s claim so allowed under the said act
of March seventh, nineteen hundred, whose husband diced after the said
war, she rhall 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........ of
rrr , in the State of Virginia, do certify that I am per-
sonally acquainted with...............0+. , 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
ACTS OF ASSEMBLY. 495

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.............. ,19..

16. That after an application has been once so passed, approved and
allowed, it shall only be necessary for the applicant, annually thereafter,
on or before the twenty-fifth day of March, to file with the auditor of
public accounts an affidavit of the applicant, supported by the oaths of
two witnesses of well-known reputation for truth, honesty, and integ-
rity, 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
oaths of the witness, and the certificate of such officer thereto, shall be in
the form and substance following—to-wit :

| Pnmene , of the county of................ , in the State
of Virginia, do solemnly swear that I am the identical person named in
original application, dated on the...... day of.............. 19.

and who filed the said application 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 be-
tween the States, and that I am now an actual resident of the county of
cece cece ees , in the said State (if a widow, and that I have not married
since the date of the filing of my said application), and that I do not
hold any national, State, city, or county office which pays me in salary or
fees one hundred and fifty dollars per annum; nor have I an income
from any other employment, or other source whatever, which amounts
to one hundred and fifty dollars per annum; nor do I receive from any
source whatever money or other means of support amounting in value to
the sum of one hundred and fifty 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 her benefit, either real,
personal, or mixed property or estate, either in fee or for life, of the
assessed value of five hundred dollars; nor do I receive any aid or pen-
sion 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 or any other
public institution (if a widow, and I am without any means of support,
either direct or indirect).

Subscribed and sworn to before me, ............02 02 ee eee , In and
for the county of.............. , this...... day of.............04. ,
19..

We, .. ccc ee cece eee ANd... . 2. eee eee eee , of the county of
occ e cece cent eee ones , in the State of Virginia, do solemnly swear

that we are personally acquainted with................. , 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 an-
nexed affidavit to be true.

Subscribed and sworn to before me, .............0eeeeeees , in and
for the............ 0) , and I do certify that the
BUI. case aes saat nanateas C6 , whose names are
signed to the annexed jurat, are persons of well-known reputation for
truth, honesty, and integrity, and residing in the said............

And it shall be the duty of the auditor of public accounts, upon re-
quest, 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 his
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. And the auditor shall strike from the
pension roll the names of all pensioners whose income exceeds one hun-
dred and fifty dollars, or whose property exceeds, in assessed value, five
hundred dollars, as hereinbefore provided.

1%. That no fee or other compensation shall be charged or received
by any clerk, attorney, officer, or other person for any service rendered
to any applicant under the provisions of this act; and any person who
shall purchase from a soldier, sailor, or marine, or from any widow of
any deceased soldier, sailor, or marine, any claim allowed under the pro-
visions of this act for a price or sum of money less than the full amount
thereof shall be guilty of a misdemeanor, and upon indictment and con-
viction thereof shall be fined or imprisoned, or both, at the discretion of
the court. The provisions hereby made for disabled soldiers, sailors, or
marines, and widows of deceased soldiers, sailors, or marines, shall be
exempt from levy, garnishment, or attachment for any debt or pecuniary
demand.

18. That for the proper discharge of his duties under this act the audi-
tor of public accounts shall be allowed to employ such clerical help as
he may need to carry out the provisions of this act, the expense thereof
not to exceed nine hundred dollars per annum. The cost of such clerical
help and the expense of printing, postage, books, and advertisements
provided by this act shall be paid out of the sum of money hereinafter
appropriated.

19. That any person who shall wilfully swear falsely as to any mate-
rial fact stated in any application, or as to any material fact contained
in any affidavit filed in support of such application, or as to any mate-
rial fact touching any application filed under the provisions of this act,
shall be deemed guilty of perjury, and that any person who shall wilfully
certify falsely as to any material fact touching any application filed un-
der the provisions of this act shall be deemed guilty of a misdemeanor,
and upon indictment and conviction thereof shall be confined in jail not
exceeding one year, or be fined not exceeding one hundred dollars, or
both, in the discretion of the court. Within the meaning of this act any
fact shall be deemed material which tends to show that the applicant is
entitled to relief under the provisions of this act.

20. That the sum of three hundred thousand dollars, or so much
thereof as may be necessary, be, and is hereby, appropriated for the year
ending September thirtieth, nineteen hundred and two, and for each
year thereafter, to meet the requirements of this act, payable out of any
money in the treasury not otherwise appropriated. From the amount
hereby appropriated the auditor of public accounts shall first pay in full
the pensions of all persons upon the pension rolls under or by virtue
of the pension act approved March fifth, eighteen hundred and eighty-
eight, whose names have not been stricken therefrom under the pro-
visions of this act; and, second, pay in full the pensions of all persons
upon the pension rolls under or by virtue of any special act of relief
heretofore passed by the general assembly and approved, whose names
have not been stricken therefrom under the provisions of this act; and,
third, if there remain sufficient, pay in full the pensions of all persons
upon the pension rolls under or by virtue of the pension act approved
March seventh, nineteen hundred, and of this act, whose names have not
been stricken therefrom under the provisions of this act, and if there be
not sufficient to pay them in full, then the auditor shall distribute the
residue of said appropriation pro rata among the said pensioners under
the said act of nineteen hundred and of this act, having regard to the
amount each is entitled to receive according to the classification pre-
scribed by section one of this act, whose claims have been filed in his
office prior to September first in each and every year.