APPLICATION FOR A TRANSFER.
No Pensioner will be transferred to a State without he or she is a permanent resident therein, or to an Agency without their residence is within the district. The official character and signature of the acting Magistrate must be certified to. If personally known to the Pension Agent, or the certificate is on file at the Agency, his certificate of official character is sufficient.
State of Florida, County of Duval, SS:
On this the 4th day of February, 1899, before me, a Notary Public, personally appeared Susan Ann Dove a resident of now Duval County Florida, who, being duly sworn, declares that she is the same person whose name was placed, on the 19th day of April, 1865, upon the list of * [left blank] pensioners, at the rate of 12 Dollars [left blank] Cents per month, from the first day of May, 1886
That said pension was last paid at the Pension Agency of at Knoxville Ten to the 4th day of November 1898, but now desires and applies for the payment of said Pension at, and the transfer of her name to the roll of the pension Agency+ and now wants to be paid at Jacksonville Florida having changed her residence from Newbern Noth Carolina to Duval County and State of Florida. Jacksonville Duval County Florida.
Susan Ann Dove
<X>
Post Office Address, Jacksonville Duval Co Florida.
Sworn and subscribed to before me, the day and year aforesaid.
P. B. Bedford
* Insert "Army" or "Navy."
+ Insert the reasons for requesting the Transfer.
EVIDENCE OF IDENTITY.
State of Florida, County of Duval, SS.
I, P B Bedford, in the County above named, do hereby certify that I have the most satisfactory evidence,* viz: Susan Ann Dove formily of Newbern NC. is now a resident of Duval County, and state of Florida. personal knowledge and that Susan Ann Dove, who has this day appeared before me to take the oath of identity, is the identical person named in the Pension certificate, which he has exhibited before me, numbered 147996, and bearing date at the 14 day of February, the 14th day of February, 1871, and signed by by W J Cato, Secretary of of the Interior
GIVEN UNDER MY HAND at Jacksonville, this the 4th day of February, 1899.
P. B. Bedford
Notary Public
N. B. — When the Pensioner is personally know to the Agent, and he will certify to his identity, the annexed form may be dispensed with. The number of Pension certificate is sometimes on the back of it.
* Here state what the evidence is—whether personal knowledge or the affidavits of respectable persons, giving their names.
