Department of the Interior
Bureau of Pensions
Washington, D.C., July 10, 1901

Special Examination Division
Ctf No 501,953
Soldier Thomas J Longley
Co F 77 Reg't Ohio Vol Inf
Enlisted Nov 1861
Discharged Feb 1866

Mr. Samuel J Henry
Stockport - Morgan Co. - Ohio

Sir,
To aid this Bureau in the settlement of the above-described claim for pension, you are requested to answer the questions noted below.
You will please fill out, sign, an return this circular, even though you do not remember the soldier or that he was wounded, disabled, or diseased in the service.
The enclosed official envelope for your reply requires no stamp.
Very respectfully,
M Clay Evans
Commisioner

Q. Do you remember the soldier, Thomas J Longley as a member of your company?

Ans. ____________

Q. Do you remember that he suffered with any wound, injury, or disease while in service?

Ans. ____________

Q. If you do remember any such wound, injury, or disease, state the nature of the same.

Ans. _______

(signature:) _______
(address:) _____

Updated on Saturday, 08-Sep-2018 16:08:41 MDT