Matthias T. Hepner, Declaration for Disability Army Pension

ORIGINAL DISABILITY CLAIM

FOR

PENSION,

Under Act of Congress, June 27, 1890

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Mathias T. Hepner

Co. D, 29" Reg't,

Indiana Vols.,

Enlisted Sept. 10[,] 1861

Discharged June 27[,] 1862

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Claim No. [blank]

Certificate No. 362,802

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FILED BY

WILLIAM H. LOPP,

INDIANAPOLIS, IND.,

ATTORNEY FOR CLAIMANT.

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TEXT:

DECLARATION FOR DISABILITY ARMY PENSION.

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State of Indiana, County of Starke ss:

On this 8 day of August, one thousand eight hundred and ninety-[blank] personally appeared before me, a Clerk of a Court of Record, within and for the County and State aforesaid, Mathias T. Hepner, aged 58 years, who, being duly sworn according to law, declares that he is the identical Mathias T. Hepner who was enrolled in the service of the United States on the 10 day of Sept. 1861, as a Private in Company D of the 29" Regiment of Ind. Vols., commanded by Capt. Jos. P. Collins, and was HONORABLY DISCHARGED at Louisville State of Kentucky, on the 27 day of June 1862.

That he is suffering from the following disabilities which are of a permanent character, viz:

Loss of right arm, Rheumatism, Malarial Poisoning, Piles & Disease of Stomach.

That the disabilities are not the result of any vicious habits of the claimant, and they incapacitate him from the performance of manual labor in such a degree as to render him unable to earn a support.

That he is now receiving an invalid pension of $8.00 per month under Certificate No. 362,802, for Injury of Back and Left Hip.

That he ---- made application for a pension that has not been allowed. The No. of Claim is ----.

That he has not been employed in the Military or Naval Service otherwise than above stated,

That he has not been employed in the Military or Naval Service otherwise than as stated above, since the [blank] day of [blank] 18[blank]. Since leaving the service he has resided in Starke Co. Indiana, and his occupation has been that of a officer[.]

That prior to his entry in the service above named, he was a man of good, sound physical health, being, when enrolled, a Co. Sheriff. That he is now, as above stated, disabled from obtaining his subsistence by manual labor by reason of his injuries and disabilities as above described.

He therefore makes this declaration for the purpose of being placed on the pension roll of the United States, under Act of Congress approved June 27, 1890.

He hereby appoints, with full power of substitution and revocation, WILLIAM H. LOPP, OF INDIANAPOLIS, IND., his true and lawful attorney to prosecute his claim, agreeing that a fee of ten dollars be paid to him upon the allowance of this claim.

He has --- received ---- applied for a pension. His post office address is Knox, County of Starke, State of Indiana.

Claimant's Signature, Matthias T. Hepner.

Also personally appeared T. J. Thompson, residing at Knox Ind., and M. L. Bozarth, residing at Knox Ind., persons whom I certify to be respectable and entitled to credit, and who, being by me duly sworn, say they were present and saw Matthias T. Hepner, the Claimant, sign his name (or make his mark) to the foregoing declaration and power of attorney; that they have every reason to believe, from the appearance of said claimant and their acquaintance with him, that he is the identical person he represents himself to be; and that they have known him for several years last past; that his habits have been uniformly good; his occupation a town Clerk, and that they have no interest in the prosecution of this claim.

Two witnesses who can write to indentify Claimant and witness Claimant's signature to the declaration{

M. L. Bozarth

T. J. Thompson

Sworn to and subscribed before me, this 8 day of August A. D. 1892 and I hereby certify that the contents of the above declaration, etc., were fully made known and explained to the applicant and witnesses before swearing, including the words [blank] on line [blank] erased, and the words [blank] on line [blank] added; and that I have no interest, direct or indirect, in the prosecution of this claim.

James C. Fletcher

Clerk S. C. C.

Acknowledge this paper before an officer having a seal; no other.

[stamped received] AUG 15 1892, U. S. PENSION OFFICE.