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2438A Application of disabled veteran Thomas Burk for state aid, April 29, 1868
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2438A Application of disabled veteran Thomas Burk for state aid, April 29, 1868
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2438A Application of disabled veteran Thomas Burk for state aid, April 29, 1868
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To the sad—e9° Selectmen o ..._. .. 2... <br /> The undersigned..- _--- _-:-- -4-- -- --- --- ----------- --------- --- -------aged.....0 )� ars,having a residence <br /> in the Gat3;--Town—of....: _> 3.:. . .............................................who served as a----- --------- <br /> in the Army—Airv�of the United Stat to the credit of Massachusetts during the late war, and now residing within the ! <br /> State; and who is wholly or partially sabled by wounds received, or by sickness and disability contracted in said service,and <br /> has an honorable discharge therefrom, hereby presents his application for State Aid, under the provisions of chapter 172, Acts <br /> Of 1866. <br /> 15 ..I� ...... .. ... .:. . -- -------------_----aforesaid do upon m oath declare and sa <br /> C���--%� � P Y Y� <br /> that I enlisted et.-c��1? : :. .............. .........and was mustered into these vice of the United St tes on / <br /> the- - o-..day of..... � �. in the year 18 ., for or on the quota off// : 1. / <br /> w/v 22 <br /> in Co any...(�...., .......t;/..0 .:..Regiment Mass. Vol... ................... ---------------------------- to serve r .._.... <br /> years, ................................ ........ where I served until the-.f4-'.day of <br /> ���j` •.-•--• in the year 186.�,when, by reason ot"disability-Tomas discharged from, <br /> said service. <br /> I equently,viz., on the.......................day of.......................................in the year 186.........enlisted.,in Company............... <br /> ..........Regt..........:..........:.......... ------------_---to the credit of.._...................................-----..... in which....................._------...._.I <br /> served until the...............................day of.............................. <br /> , was n y m g the <br /> duration of my whole service having been....._�Z----------years..........months...../_/--..........days. <br /> My reason for claiming State Aid is,that I w disabled while in the United Sta es Service,viz., on'th . ....—........... <br /> day of...... .. . . ::..:. .. 86. ..._ at.. .. ... •...., ... ..�..... ..... 9 <br /> n , and I are that I s actua y isabled by re son of sue!-' <br /> ue ickness�,�g <br /> wounds,or casualties;and that said disability still Conti es. <br /> er claim for my wife.............................................................................to whom I was married on the----- _.......--------day of <br /> ............................... ----------------------186.........and my child....................................................................born on the------------- ----...day <br /> of------------------------------------------ .....186.................................. <br /> .. ............................................................... -•-.................... .................................:................................------------------------------- ------ --------- <br /> .. .........................••--•----••--••-•... ......--••--•---------•--•----. • .................... ....................... -- ....................................................................... <br /> both of whom were and are dependent upon me,are in necessitou ircumstances, now have a residence in said................................ <br /> and were residing within the State at the passage of the Act above nam d. <br /> And I further:declare that neither in self-nor Any one dependent upon or claiming aid-on my_acemant, are receiving..a,id <br /> from any other State, nor from any other town in this State under the provisions of the Act aforesaid, and that at the <br /> passage of said Act I was and am now an inhabitant of the Commonwealth of Massachusetts. <br /> Dated at V. 86 Signed,.__.i�� <br /> 49ommonwcalt4 of Alaooac4uoc##o. <br /> 417 <br /> ss. :...:.. _. . ...... ..............186t/Then personally appeared the above-named <br /> -ram .... ..... .........and made oath at the foregoing statement by him subscribed,is true, according to <br /> his best knowledge and belief.. <br /> Before me, <br /> Justice of the Peace. <br />
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