Matthias T. Hepner, Declaration for Pension
3-014.
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ACT OF FEBRUARY 6, 1907.
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CLAIM FOR PENSION.
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Certificate No. 362,802
Name, Matthias T. Hepner
Service, D. 29. Ind. Inf
H. 151. Ind. Inf
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INSTRUCTIONS
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This form may be used for original pension or increase of pension.
Declaration and testimony is support of same to be executed before some officer of a court of record having custody of its seal, a notary public, justice of the peace, or other officer authorized to administer oaths for general purposes. If such officer is not required by law to have and use a seal, his official chracter, signature, and term of office must be certified by the proper State, county, or city officer under his official seal, unless such certificate has been filed in the Bureau of Pensions for general reference.
[stamped received] APR 12 1909, LAW DIVISION
[stamped received] APR 14 1909, RECORD DIVISION
[Text of Act reproduced on form is here omitted]
TEXT:
3-014
ACT OF FEBRUARY 6, 1907
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DECLARATION FOR PENSION.
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THE PENSION CERTIFICATE SHOULD NOT BE FORWARDED WITH THE APPLICATION
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State of Indiana
County of Stark } ss.
On this 9th day of April, A. D. one thousand nine hundred and nine, personally appeared before me, a Notary Public within and for the county and State aforesaid, Matthias T. Hepner, who, being duly sworn according to law, declares that he is 75 years of age, and a resident of Knox, county of Starke, State of Indiana, ; and that he is the identical person who was ENROLLED at Knox, Indiana, under the name of Matthias T. Hepner, on the 13th day of September, 1861, as a corporal, in Company D, 29th Reg. Ind. Vols., in the service of the United States, in the Civil war, and was HONORABLY DISCHARGED at Louisville, Ky., on the 18th day of June, 1862,
That he also served as First Lieutenant, Co. H, 151st Reg., Ind. Vols. Enrolled at Knox, Ind., Feb. 26, 1865, and Honorably discharged with regiment.
That he was not employed in the military or naval service of the United States otherwise than as stated above. That his personal description at enlistment was as follows: Height, 5 feet 9 inches; complexion, fair; color of eyes, blue; color of heair, auburn; that his occupation was Sheriff; that he was born April, 9, 1834, at Miami County, Ohio.
That his several places of residence since leaving the service have been as follows:
Knox, Starke County, Indiana,
That he is [blank] a pensioner. That he has [blank] heretofore applied for pension #362,802
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 February 6, 1907.
That his post-office address is Knox, county of Starke, State of Indiana.
(Claimant's signature in full.) Matthias T. Hepner
Attest: (1) James C. Fletcher
(2) Charles S. Peters
Also personally appeared James C. Fletcher, residing in Knox, Indiana, and Chrles H. Peters, residing in Knox, Indiana, persons whom I certify to be respectable and entitled to credit, and who, being by me duly sworn, say that they were present and saw Matthias T. Hepner, the claimant, sign his name (or make his mark) to the foregoing declaration; that they have every reason to believe, from the appearance of the claimant and their acquaintance with him of 27 years and 10 years, respectively, that he is the identical person he represents himself to be, and that they have no interest in the prosecution of this claim.
James C. Fletcher
Charles H. Peters
[stamped] Validity accepted
S. A. Cuddy
Chief, Law Division
Per CBH
Subscribed and sworn to before me this 9th day of April, A. D. 1909, 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], erased, and the words [blank], added; and that I have no interest, direct or indirect, in the prosecution of this claim.
Edward H. Taylor
Notary Public
My commission expires Feb.25, 1910
[stamped received] APR 12 1909, U. S. PENSION OFFICE.
Transcription by John C. Hepner, 1999.