Arrears Act, July 27 - 68 - [handwritten at top]
CLAIM FOR WIDOW'S PENSION.
BRIEF in the case of Mary Rollins, Widow of Calvin Rollins, corpl., Co. A, 11 U.S. Cold. Vols resident of Shelby County and State of Tenn.
Post Office address: Memphis, Tenn.
DECLARATION AND IDENTIFICATION IN DUE FORM.
Service. Adjt. Genl. reports him mustered July 28, 1863 & "Missing after battle at Fort Pillow, April 12, 1864 supposed to be killed."
Death. Two members of his Co. swear that they were with him when he was shot & saw him die at Fort Pillow, April 12, 1864.
Marriage. Nov. 11, 1859. Proved by eye-witnesses.
Names and dates of birth of children. None-
Agent and his P. O. address. Justus I. McCarty, Present.
Admitted Nov. 18, 1868, to a Pension of $8.00 per month, commencing April 13, 1864, deducting former payments.
M. L. Story, Examining Clerk.