ACCEPTED
July 8.13
No
. 11.314STATE OF TENNESSEE
Wid I. #6501
Soldier’s Application for Pension
M. F. Smith
Filed
June 12.09Allowed
Read Specifications on Back
1. State Octo 16.12
2.
3.
4.
5.
President
Secretary
Board of Pension Examiners
FOSTER, WEBB, & PARKER NASHVILLE
To Applicants for Pension:
The material facts to be proven in the pension claim, under the laws of the State of Tennessee, are as follows:
1. Service in the Army
2. Present Disability
3. Indigency
4. How you got out of the Army
5. Character as a Soldier and Citizen
M. F. Smith
Post Office
R. R. No 1
Indian Mound
Tennessee
1. May be proven by officers or comrades.
2. May be proven by physician’s certificate.
3. May be proven by neighbors and by a certificate of County Trustee.
4. May be proven by filing parole or discharge, or in case these have been lost or destroyed, by officers or comrades who know the facts.
5. May be proven by comrades and citizens.
Soldier’s Application of Pension
I,
M. F. Smith , a native of the State of Tennessee and now a citizen of Tennessee, resident at Modoc, Dist No 4, P. O. R.#1 Indian Mound in the County of Montgomery in said State of Tennessee, and who was a soldier from the State of Tennessee , in the war between the United States and the Confederate States, do hereby apply for aid under the Act of the General Assembly of Tennessee, entitled "An Act for the benefit of indigent and disabled soldiers of the late war between the States, and to fix the fees of attorneys or agents for procuring such pensions , and fixing a penalty for violation of the same." And I do solemnly swear that I was a member of 14th Tenn, W. A. Forbes Colonel, Ed Hewett, Capt when organized, W. A McCombs Col, A. C. Collins Capt, when disbanded in the service of the Confederate or United States, and by reason of disability or indigence I am now entitled to receive the benefit of this Act. I further swear that I do not hold any National, State, or County office, nor do I receive aid or pension from any other State, or from the United States, and that I am not an inmate of any soldiers’ home, and I am unable to earn a reasonable support for myself and family. I do solemnly swear that the answers given to the following questions are true:In what County, State, and year were you born?
Answer
When did you enlist and in what command? Give the name of the regimental and company officers under whom you served?
Answer
In what battles were you engaged, and if not wounded, state what disabilities did you receive, if any?
Answer
What was the precise nature of your wound or disabilities, if any?
Answer
Were you incapacitated for service by reason of said wound or disability incurred?
Answer
Were you discharged from the army by reason of said wound or disability?
Answer
If discharged from the army, where were you and what did you do until the close of the war?
Answer
What was the name of the surgeon that attended you?
Answer
How did you get out of the army, when and where?
Answer
Were you ever in prison? If so, state what prison and when released.
Answer
Were you paroled? If so,, when and where?
Answer
Did you take an oath of allegiance to the United States Government?
Answer
If so, when and under what circumstances?
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Are you married, or have you been married?
Answer
If so, what is the size of your family living together?
Answer
What are the respective ages of your wife and children living with you?
Answer
To what sex do your children belong?
Answer
Are some of your children able to support you?
Answer
In what business are you engaged, if any, and what do you earn?
Answer
What estate have you in your own right, real and personal, and what is its value?
Answer
What estate has your wife in her own right, real and personal, and what is its value?
Answer
How have you derived support for yourself and family for the last five years?
Answer
Do you take intoxicants to any extent?
Answer
How long have you been an actual resident of the State of Tennessee?
Answer
Have you an attorney to look after this application?
Answer
If so, give his name and address.
Answer
Witness my hand this
14th day of April 190 9 .WITNESSES
STATE OF TENNESSEE,
Montgomery
County. ý I, H. C. Stafford Trustee of said County,Certify that
M. F. Smith and his wife Blanche are assessedWith
20 acres, valued at $ 300.00 , and with $ No of personal property.Witness my hand this
23 day of April 190 9 .A. C. Stafford Trustee
If applicant and his wife have no property the Trustee must so certify.
STATE OF TENNESSEE,
Montgomery
County. ý Personally appeared before me, Alex BaynhamWitness my hand and seal of office, this
14th day of April 190 9 .Alex Baynham
STATE OF TENNESSEE,
Montgomery
County. ý Personally appeared before me, Alex BaynhamWitness my hand and seal of office, this
8th day of June 190 9 . Alex Baynham P. F. Bellamy, M. D.
N. P
STATE OF TENNESSEE,
Montgomery
County. ý Personally appeared before me, Alex BaynhamState here what witnesses know of their own knowledge.
W. H. Bryant of the 14th Tenn. Reg
I, J. T. Jenkens was with M. F. Smith in the war between States, We were members of the 14th Tennessee & said Smith made a faithful soldier, & remained ^with his regiment until captured. James T. Jenkins
Witness my hand and seal of office, this
23 day of April 190 9 .Alex Baynham