bostwickdis

Act of June 27, 1890

Declaration for Disability Pension

To be executed before a Court of Record or some officer
thereof having custody of its seal.

State of Ohio, County of Montgomery, ss:

On this 15 day of Oct., A. D. one thousand eight hundred
and ninety-0, personally appeared before me, Dept Clk of
the _____, a court of record within and for the County
and State aforesaid, James H. D. bostwick, aged 44
years, a resident of the Dayton, County of Montgomery,
State of Ohio, who being duly sworn according to law,
declares that he is the identical ________, who was
enrolled on the 19th day of January, 1864, in Co. B, 10
Ohio Cavalry in the war of the rebellion, and served at
least ninety days,, and was HONORABLY DISCHARGED at
Cleveland, Ohio, on the 10 day of August, 1865. That he
is unable to earn a support by reason of General
Disability.
That the said disabilities are not due to his vicious
habit, and are to the best of his knowledge and belief permanent. I
never stagered from the efferts of sprites of any nor had any
private disease. That he has applied for pension under
application No. 618026. That he makes this declaration
for the purpose of being placed on the pension roll of
the United States, under the provisions of the act of
June 27, 1890.

He hereby appoints with full power of substitution and
revocation, James H. D. Bostwick of Dayton his true and
lawful attorney to prosecute his claim. That his
POST-OFFICE ADDRESS is City of Dayton, County of
Montgomery, State of Ohio.

Signed: James H. D. Bostwick

attest: Abel M. Rawer
V. R. Huffman