91st PA--Pension Office forms

Pension Office forms

(Note: I've just started collecting this list, to help understand Pension Office memos.)

(more information about pensions)
Circular 2
instructions for proving dependence for mother's pension application
Circular 6
request for information about death from Surgeon General
Circular 9
request for further information about death (from commissioned officers, surgeons or physicians, etc.)
Circular 10
Circular 14
request for official information about date and cause of death (from the Surgeon General's office)
Circular 16
request for official evidence about enrollment, muster, service, duty, and cause of death
Circular 20
Circular 21
request for filling out a certificate giving information about the cause of a soldier's death, and whether it occurred in the line of duty

Circular 2

[transcribed from page 38 of the widow's pension certificate file for Francis Carrigan, without the handwritten additions]
ACT OF JULY 14, 1862.
CIRCULAR No. 2.
DEPARTMENT OF THE INTERIOR,
PENSION OFFICE,
[blank], 186[blank]
SIR:

In the case of [blank], No. [blank], further proof of dependence must be furnished, in accordance with the following instructions, which should be carefully examined and strictly complied with:

The claimant, having shown by the testimony of competent witnesses that she was the mother of the deceased soldier, and that he left neither widow nor minor child surviving, must also establish her dependence upon him for support by proving--1st That, previous to her son's decease, her husband had died, the date of his death being stated, or that he had permanently abandoned his family, the date of such desertion and that he has not since returned being shown; or that, through sickness or other unavoidable cause, which still exists, he was unable to support the claimant; his habits, and the nature, degree, and duration of the disability being shown by medical testimony, affiant's professional standing being certified.

2d. The amount of property or other means of support possessed by the claimant while she was receiving the contributions of her son, and since, must be shown.

3d. It must be proven to what extent, for what period, and in what particular manner, whether by paying rent, board, or other necessary expenses, the son contributed to claimant's support, the statements on these points being full and definite.

Witnesses must depose as to their interest in the claim, and the source of their information, and the person administering the oath must certify as to their credibility, and that he has no interest, and that the affiants, if they sign by mark, knew the contents of the paper or papers before so signing, and his signature and official character must be duly authenticated under the seal of a court of record.


Respectfully, yours,
JOSEPH H. BARRETT,
Commissioner.

N.B.--Endorse the words "Additional Evidence" upon the envelopes of all papers addressed to this office upon business already before it; also, the number of the application to which they refer, and the name of the claimant, and of the State where the party resided when the claim was filed.


(Circulars [to?] be returned with evidence.)

Circular 6

[transcribed from page 56 of the dependent's pension certificate file for William S Willis (E), without the handwritten additions]
(No. 6.)
Department of the Interior,
PENSION OFFICE,
[blank], 18[blank].

Sir:

You are respectfully requested to furnish official evidence of the date and cause of death of [blank], who was a [blank], in Company [blank], [blank] Regiment of [blank], who is reported to have died at [blank], on the [blank] day of [blank], 18[blank], of [blank]

If the soldier was in hospital, give full record, embracing date and cause of admission; for what treated; and, if furloughed or discharged, on what account and at what date.

Please return this circular with your report.



No. [blank]

Respectfully, yours,
[blank]
Commissioner.

Surgeon General, U.S.A.,
Present.
Room No. [blank]

Circular 9

[transcribed from page 43 of the widow's pension certificate file for Martin Blake, without the handwritten additions]
(ACT OF JULY 14, 1862.--CIRCULAR No 9)
DEPARTMENT OF THE INTERIOR,
PENSION OFFICE,
[blank], 186[blank]
SIR:

In the case of [blank], No. [blank], the official evidence of the soldier's death is incomplete. It is therefore necessary that a certificate should be procured, if possible, from his Regimental Surgeon, or from some other commissioned officer having personal knowledge of the facts, stating when, where, and under what circumstances the injury was received, or the disease contracted, which was the cause of the soldier's death, giving the name and character of the disease, and date of death. If it be shown that the certificate of a commissioned officer now in actual service cannot be obtained, the facts may be proved by the affidavits of other persons having the requisite knowledge.

Should the officer certifying not be in actual service, he must make oath to his certificate, and it must be authenticated by the seal of a court of record.

If the soldier was attended in his last illness by a Civil Surgeon or Physician, the affidavit of such Surgeon or Physician, showing the character of the disease, or injury, and date of death, must be furnished, in addition to the proof by certificate, or affidavit, as to the origin of the disease, or injury, above required.

The credibility and professional standing of the Civil Surgeon or Physician must be certified.


Respectfully, yours,
[blank]
Commissioner.

N.B.--Endorse the words "Additional Evidence" upon the envelope of all papers addressed to this office upon business already before it; also, the number of the application to which they refer, and the name of the claimant, and of the State where she resides.

Circular 10

[the dependents' pension file for Francis Corle mentions this on page 33]

Circular 14

[transcribed from page 32 of the widow's pension certificate file for Aaron K Vanarsdale]
(No. 14.)
Department of the Interior.
PENSION OFFICE.
[blank], 186[blank]
Sir:

You are respectfully requested to furnish official evidence of the date and cause of death of [blank], who was a [blank] in Co. [blank], [blank] Regiment of [blank] Volunteers, who is reported to have died at [blank] on the [blank] day of [blank], 186[blank], of [blank]

If the soldier died in hospital, state also at what date he was admitted to the same and for what he was treated.

Respectfully, &c.,
[blank]
Commissioner.

No. [blank]
SUrgeon Gen'l U.S.A.

Circular 16

[transcribed from page 18 of the dependent's pension certificate file for David Irvine]
[note that it was sent to other organizations also--for example, to the Paymaster General (see page 51 of the dependent's pension certificate file for Aaron K Varnasdale)]

(No. 16.)
Department of the Interior,
PENSION OFFICE,
[blank], 186[blank]
Sir:

You are respectfully requested to furnish official evidence of the enrollment, muster, service, duty, and cause of death of [blank], who was a [blank] in Co. [blank], [blank] Regiment of [blank] Vols., reported died [blank], 186[blank], [blank]

If the above name is not found on the Rolls of said Company, will you so state, and report as to enrollment, &c., in the case of any man bearing a similar name whom you have good reason for believing to be the soldier inquired for. When the Rolls show him to have been a Prisoner of War, let that fact be reported.


[blank]

Please attach this Circular to your report, and return the same to this Office.

No. [blank]


Respectfully, yours,
Joseph H. Barrett
Commissioner.

The Adjutant General, U.S.A., Washington, D.C.

Circular 20

[the dependents' pension file for Francis Corle mentions this on page 33]

Circular 21

[transcribed from page 21 of the dependent's pension certificate file for Charles A Mellor]
(No. 21.)
Department of the Interior,
PENSION OFFICE,
[blank], 186[blank].

Sir:

You are respectfully requested to fill out, over your official signature, the accompanying blank certificate, stating when, where, and under what circumstances the injury was received, or the disease contracted, which was the cause of the soldier's death, giving the name and character of the disease, the place and date of death, and stating whether or not contracted in the line of duty.

Please forward your report directly to this Office, having endorsed on the envelope, over your official signature, "Official Business."


Respectfully, yours,
Joseph H. Barrett
Commissioner of Pensions.
To [blank]

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revised 1 Jan 15
contact Harry Ide at [email protected] with comments or questions