David Smith Hepner, Pension File, Application for Burial Flag

VETERANS ADMINISTRATION

Form 2008 Rev. Sept. 1933

no case

APPLICATION FOR BURIAL FLAG

The undersigned hereby makes application for a regulation burial flag to drape the casket of David S. Hepner, "C" No. [blank] (or if "C" number is not available) whose rank and organization in the active service was Co. D. 29th Ind. who died at D 2577028 [this is written in space for (Number) and (Street) but appears to have been added later] Tipton Iowa on Feb 12 1936 and who will be buried at ["shipped to" lined out] Tipton (indicate by "X") Tipton Iowa on Feb. 14 1936

The deceased was an honorably discharged veteran of the Civil War war.

I am the (See Paragraph 1 of instructions) Funeral Director

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I agree, if flag is issued, to comply with Par. 2 of Instructions on this form.

I certify that to the best of my knowledge and belief the statements made above are correct and true; that a flag has not been previously applied for or furnished for the above deceased veteran; that I have carefully read Paragraphs 1 to 3 of the Instructions and that this application is not submitted in violation of Section 35 of the Criminal Code, which provides a fine of not more than ten thousand dollars, or imprisonment for not more than ten years, or both, for presenting any claim against the Government of the United States, knowing said claim to be false and with intent to defraud.

Feb 13 1936.

Fred B. Wilson (Signature)

Address: Tipton Iowa

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RECORD OF ACTION TAKEN

(Show action taken by letter "X")

X Approved for issue.

Disapproved, flag not issued.

(Signature of Issuing Official) Robert M. Tracy

Tipton Iowa

Feb. 14, 1936

Acting Postmaster

Post Office

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RECEIPT OF FLAG ACKNOWLEDGED: Fred M. Wilson (Signature)

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