Balaam Bolin, Declaration for the Increase of an Invalid Pension, 1892

TEXT:

Declaration for the Increase of an Invalid Pension,

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State of Indiana County of Morgan, ss:

ON THIS 2^nd day of Sept., A. D., 1892, personally appeared before me a Clerk ct ct in and for the County and State aforesaid, Balam Bolin aged 62 years, a resident of the county of Morgan State of Indiana, who, being duly sworn according to law, declares that he is a pensioner of the United States, enrolled at the Indianapolis Pension Agency at the rate of 12 dollars per month, Certificate No. 267380 by reason of disability from Chronic Diarrhea and resulting disease of rectum incurred while serving as a Private in Company "B" 67 Regiment of Indiana Volunteers. That he believes himself to be entitled to an increase of pension on account of increase of disability for which pension was granted [blank] that he hereby appoints with full power of substitution and revocation, J. J. JOHNSON, Martinsville, Ind., his true and lawful attorney, to prosecute his claim. His Post Office address is Martinsville Morgan County Ind

(Signature of Claimant.) Balaam Bolin

[witnesses section blank and crossed out]

Sworn and subscribed before me this 2^nd day of Sept, A. D., 1892 and I hereby certify that the contents of the above declaration, &c., were fully made known and explained to the applicant and witnesses before swearing, including the words --- erased, and the words --- added; and that I have no interest, direct or indirect, in the prosecution of this claim.

R. C. Griffitt Clerk

Morgan Ct. Ct.