William T. Hepner, Declaration for an Original Invalid Pension

DECLARATION FOR AN ORIGINAL INVALID PENSION.

This must be Executed before a Court of Record or some Officer thereof having Custody of the Seal.

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State of Iowa, County of Ida}ss

On this 21st day of May, A. D. one thousand eight hundred and eighty --- personally appeared before me a Clerk of the District Court a Court of Record within and for the county and State aforesaid, Wm T. Hepner aged 47 years, who, being duly sworn according to law, declares that he is the identical Wm T. Hepner who was ENROLLED on the 11th day of Sept., 1861, in company D. of the 29" regiment of Indiana Volunteers commanded by Capt. J. P. Collins, and was honorably DISCHARGED at Battle Creek Tenn. on the 29 day of July, 1862; that his personal description is as follows: Age, [blank] years; height, 5 feet 9 inches; complexion Light; hair, Brown; eyes, Brown. That while a member of the organization aforesaid, in the service and in the line of his duty at Camp Nevin, in the State of Ky on or about the 10 day of November, 1861, he contracted piles from exposure & constipation and has suffered from said disabilities ever since discharge being years so affected as to render him incapable[?] of labor on account of his [word to faint to read] about in the [word too faint to read] of [end too faint to read].

That he was treated in hospitals as follows: Camp Nevin, Ky.

N.C. Hos Louisville Ky.

Evansville, Ind.

That he has not been employed in the military or naval service otherwise than as stated above.

That since leaving the service this applicant has resided in the [too faint to read] of Cedar in the State of Iowa, and his occupation has been that of a carpenter. That he is now ----disabled from obtaining his subsistence by manual labor, by reason of his injuries, above described, received in the service of the United States; and he therefore makes this declaration for the purpose of being placed on the invalid pension roll of the United States. He hereby appoints with full power of substitution and revocation, T. W. TALLMADGE, of Washington, D. C. his true and lawful attorney to prosecute his claim. That he has never received nor applied for a pension; that his residence is No. ---- street, Tipton, Cedar Co., Iowa and that his post office address is: "

(Signature of Claimant.) William T. Hepner

(Two Witnesses who can write sign here.)

L. D. Ingman

M. B. Dean.