HomeMy WebLinkAbout2438A Application of disabled veteran Thomas Burk for state aid, April 29, 1868 To the sad—e9° Selectmen o ..._. .. 2...
The undersigned..- _--- _-:-- -4-- -- --- --- ----------- --------- --- -------aged.....0 )� ars,having a residence
in the Gat3;--Town—of....: _> 3.:. . .............................................who served as a----- ---------
in the Army—Airv�of the United Stat to the credit of Massachusetts during the late war, and now residing within the !
State; and who is wholly or partially sabled by wounds received, or by sickness and disability contracted in said service,and
has an honorable discharge therefrom, hereby presents his application for State Aid, under the provisions of chapter 172, Acts
Of 1866.
15 ..I� ...... .. ... .:. . -- -------------_----aforesaid do upon m oath declare and sa
C���--%� � P Y Y�
that I enlisted et.-c��1? : :. .............. .........and was mustered into these vice of the United St tes on /
the- - o-..day of..... � �. in the year 18 ., for or on the quota off// : 1. /
w/v 22
in Co any...(�...., .......t;/..0 .:..Regiment Mass. Vol... ................... ---------------------------- to serve r .._....
years, ................................ ........ where I served until the-.f4-'.day of
���j` •.-•--• in the year 186.�,when, by reason ot"disability-Tomas discharged from,
said service.
I equently,viz., on the.......................day of.......................................in the year 186.........enlisted.,in Company...............
..........Regt..........:..........:.......... ------------_---to the credit of.._...................................-----..... in which....................._------...._.I
served until the...............................day of..............................
, was n y m g the
duration of my whole service having been....._�Z----------years..........months...../_/--..........days.
My reason for claiming State Aid is,that I w disabled while in the United Sta es Service,viz., on'th . ....—...........
day of...... .. . . ::..:. .. 86. ..._ at.. .. ... •...., ... ..�..... ..... 9
n , and I are that I s actua y isabled by re son of sue!-'
ue ickness�,�g
wounds,or casualties;and that said disability still Conti es.
er claim for my wife.............................................................................to whom I was married on the----- _.......--------day of
............................... ----------------------186.........and my child....................................................................born on the------------- ----...day
of------------------------------------------ .....186..................................
.. ............................................................... -•-.................... .................................:................................------------------------------- ------ ---------
.. .........................••--•----••--••-•... ......--••--•---------•--•----. • .................... ....................... -- .......................................................................
both of whom were and are dependent upon me,are in necessitou ircumstances, now have a residence in said................................
and were residing within the State at the passage of the Act above nam d.
And I further:declare that neither in self-nor Any one dependent upon or claiming aid-on my_acemant, are receiving..a,id
from any other State, nor from any other town in this State under the provisions of the Act aforesaid, and that at the
passage of said Act I was and am now an inhabitant of the Commonwealth of Massachusetts.
Dated at V. 86 Signed,.__.i��
49ommonwcalt4 of Alaooac4uoc##o.
417
ss. :...:.. _. . ...... ..............186t/Then personally appeared the above-named
-ram .... ..... .........and made oath at the foregoing statement by him subscribed,is true, according to
his best knowledge and belief..
Before me,
Justice of the Peace.
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