Alachua County FlArchives Military Records.....POLK, Sam 1902 Civilwar - Pension Co. C, 7th Regt. FL Infantry ************************************************ Copyright. All rights reserved. http://www.usgwarchives.net/copyright.htm http://www.usgwarchives.net/fl/flfiles.htm ************************************************ File contributed for use in USGenWeb Archives by: Jimmy R. Polk Nascar3Fan@aol.com February 18, 2007, 9:19 am Florida Confederate Pension Application FLORIDA CONFEDERATE PENSION APPLICATION FILES Pension Application A06362 Surname: Polk Given names: Sam Service Unit: 7th Regt Inf Reference: Wife’s name: Application County & Year: Alachua Co 1902 Page 001 A6362 Page 002 APPLICATION FOR AN INCREASE IN PENSION. UNDER THE LAWS OF FLORIDA. TO THE STATE BOARD OF PENSIONS, TALLAHASSEE, FLA.: I, Sam Polk, Pensioner No. 2861, of the State of Florida under the laws of Florida do hereby make application for an increase in the amount of pension now allowed me, as per certificate of disability stated below. I am now receiving $120.00 per annum, and I am 81 years of age. Signed Sam (his X mark) Polk Applicant Address Bell Fla CERTIFICATE OF DISABILITY. PHYSICIANS’ AFFIDAVIT. (N.B. Physicians making this certificate will please answer all questions and in stating nature of disability from which applicant is suffering, state plainly the trouble, avoiding the use of technical terms.) 1. Have you examined the applicant? Yes 2. Is he personally known to you? Yes 3. Because of injuries, disease, or age, is the applicant unable to earn a livelihood by manual labor? Yes 4.. Is his physical condition such as to warrant you certifying that he is permanently and totally disabled? Yes 5. State below the disabilities from applicant is suffering, stating any loss of limbs and eyesight. Rheumatism (In case of total disability this certificate must be signed by two physicians.) Signed: Irvin P. Philpot MD Physician W. L. Lancaster Physician State of Florida ) County of Alachua) Before me an officer duly authorized to administer oaths, came this day Irvin P. Philpot and W. L. Lancaster both well known to me to be the physicians who signed the above certificate, and each for himself deposes and says that the answers above given and the statements made in the above certificate are true and correct. Each further deposes and says that he is a physician and that he is a resident of the State of Florida and of the county aforementioned. Sworn to and subscribed before me this 30th day of Sept. A.D. 1913 Charles C. Martin Notary Public Com. Exp. Nov-5-1913. (Attach Seal.) Seal affixed Page 003 Soldier’s Pension Claim Under The Act of 1909 (Form A) State of Florida ) County of Alachua) On this 6th day of September, A.D. One Thousand Nine Hundred and Nine personally appeared before me, a Notary Public in and for the county and State aforesaid, Sam Polk who, being duly sworn according to law, declares that he is 76 years of age, having been born on the 10th day of August, 1833, in the county of Lounge (sic), in the State of Georgia. That he is a bona fide citizen of the county of Alachua, State of Florida. That he has resided in the State of Florida continuously since the ….day of December 1850. That he is the identical person who enlisted at Gainesville, Fla., under the name of Sam Polk, on the ….day of May 1861, in Company Dudleys, Regiment 7 Infantry of the State of Florida in the service of the Confederate States Army (Here state whether the service claimed was in the Confederate States Army or in the service of a State.) and who was Honorably Discharged at ………………, in the State of …………., on the ……day of………., 186…, on account of …………………….(Here state fully any other military service performed by the applicant.)…………………………………………………(Here give date and place of capture, imprisonment, exchange or parole.) I was captured on the 17th day of December 1864 I think at Jarome (sic), Ga., and on 25th of December 1864 I was carried to prison at Camp Chase, Ohio, and remained there until I was paroled on June 15th, 1865. That I served faithfully until honorably captured from the service of the Confederate States Army in the year 1864 and did not desert the service of the Confederate States Army nor take the oath of allegiance to the United States until after the surrender of the Confederate Armies. (Here state whereabouts at close of Civil War.) That I was in prison at Camp Chase, Ohio. Page 004 Report of County Commissioners We, the undersigned, County Commissioners in and for the County of Alachua, Florida, do hereby report that at a meeting of the Board of County Commissioners held this day, the foregoing application of Sam Polk for a pension under the Laws of Florida, was investigated by us; that we are satisfied that the applicant does not own property (including the property of his wife) to exceed the value of $5,000, and that the representations made in the petition and affidavits are true, and that a pension should be granted to the applicant. Witness our hands this 8 day of Sept., A.D. 1909. 1. J. G. Dampier, Chairman 2. J. F. Townsend 3. C. W. Summers 4. J. W. May 5. ………………………….. County Commissioners By the County Commissioners. Attest: S. H. Wienges, Clerk Circuit Court Note—All blanks must be filled out. All information required must be fully and accurately given. 6362 Former Claim No. 1902 Application No. 17488 Pensioner No. 2861 CLAIM FOR PENSION By Sam Polk Of Trenton Post office Alachua County Late of Dudleys Company 7th Fla Regiment Filed in Pension Department Sep 15 1909 Approved Sep 23 1909 With pay from Jul 1 1909 At the rate of $120 per annum …………….Secretary of Board Filed in Comptrollers Office ………………19.. Page 005 ……………………………………………………………………………………………………………………………………………………………………………………………… That I do not own property, including real estate, personal property, stocks, bonds, mortgages or other collateral securities of any kind in this or any other State, nor does my wife own with me jointly or separately, property to exceed in value the sum of five thousand dollars. That the following is a true and correct statement of all the property owned by me or by my wife, jointly and separately in this or any other State: Real estate, located at……………………………………………………….$…………….. Cattle, horses and other live stock…………………………………………..$……………. Personal property One buggy……………………………………………….$25.00………. Stocks……………………………………………………………………….$…………….. Bonds………………………………………………………………………..$……………. Mortgages, notes or other securities……………………………………...…$……………. Total Amt………………$25.00……… That I heretofore been granted a pension from the State of Florida under pension certificate 1902, at the rate of $120.00 per annum. (Here state any disabilities, physical or mental.) I am ruptured on left side and have dyspepsia. (Here state any wounds received, or loss of limbs and eyesight.)…………………………………………………… That my post office is Trenton, County of Alachua, State of Florida. Sam (his X mark) Polk (Claimant must sign name in full.) Attest: 1. J. C. Martin 2. R. L. Tison Sworn to and subscribed before me this 6th day of September, A.D. 1909, and I hereby certify that the above declaration, etc., were fully made known and explained to the applicant before swearing, and that I have no interest, direct or indirect, in the prosecution of this claim. Samuel B. Hardee N.P. State at Large My com. expires May 22, 1912 (Notary Public Seal affixed) Page 006 (Form B.) State of Florida ) County of Alachua) We, the undersigned citizens of Alachua County, State of Florida, do hereby certify that we personally know Sam Polk, who is an applicant for a pension under the laws of Florida, and that from our own personal knowledge, and from the best information available, we believe that the applicant does not own property (including property of his wife) to exceed in value the sum of $5,000, and that the statements made by him relative to the value of his property are true and correct. (To be signed by two citizens.) J. C. Martin R. L. Tison Sworn to and subscribed before me, this 6 day of September, 1909. Samuel B. Hardee N.P. State at Large My com expires May 22, 1912 (Form C.) Physician’s Affidavit State of Florida ) County of Alachua) Before me personally came Dr. O. S. Clyatte, who being duly sworn deposes and says, that he is a physician; that he is a resident of the State and County aforesaid; that he personally knows Sam Polk the applicant named in the foregoing application for a pension. This deponent further says that he has carefully examined the said applicant’s physical condition and finds: (Here state nature, character and extent of wounds, disease or disability. Please avoid technical terms.) This is to certify that Sam Polk is ruptured on left side and has chronic dyspepsia. The deponent further states that the said Sam Polk is permanently partially disabled by reason of such diseases from earning a livelihood for himself by manual labor. (Please note carefully resolution below before certifying to total disability.) O. S. Clyatte MD Physician Sworn to and subscribed before me, the 6th day of September, A.D. 1909. Samuel B. Hardee N.P. State at Large My com. expires May 22, 1912 (Notary Public Seal affixed) At a meeting of the State Board of Pensions held July 10th, 1907, at which the Governor, Comptroller and Treasurer were present, the following resolution was adopted: Resolved: That persons entitled to Pensions under the Laws of Florida, who apply for the amount allowed in cases of total disability, must submit the affidavit of a reputable physician stating specifically the personal ailment and conditions that render the applicant entirely helpless and incapacitated, physically or mentally, for any work or business. Page 007 Soldier’s Application for Pension State of Florida ) County of Alachua) On this 27 day of November, 1902, personally appeared before me, Clerk of the Circuit Court in and for said county and State Florida (transcribers note: here should most likely be the name of the applicant for the pension instead of the word Florida) who being by me duly sworn, declares that he is the identical person who enlisted on or about the 15 day of May, 1861, in Captain R.H.B. Dudley’s Company, county of Alachua, in the State of Florida, and that while in actual service in said company …………….Regiment, of the State of ………… and in line of duty as such soldier, at ………………………, State of ……………….., on or about the ……..day of ……………., 186…, and was honorably discharged at the expiration of my service on the 14 day of June 1865, in Camp Chase county, State Ohio, I was discharged from prison. (Here state fully and clearly all facts showing the injury, its character, and especially the extent of the injury and disability resulting therefrom.) I captured at Kingston Georgia on the 17th day of December 1864, and was carried from there to Camp Chase, and remained there, until date mentioned above, and on account of my age being 70 years old I am unable to earn a living by manual labor, and that as a direct result of said injuries, thus received in line of duty during the war, I am now unable to gain a livelihood by manual labor; that I have continuously since January 1st, 1885, been a citizen of Florida; that neither I, nor my wife, nor both combined, own real and personal property to the value of $800 in this or any other State, and not purposely disposed of our property for the purpose of availing ourselves of the pension laws of Florida; that I am not otherwise enabled, or in a position to earn, and have no income from any source sufficient for a livelihood by manual labor, and that I never deserted the Confederate service, and that I receive a pension from no other source. Sam (his X mark) Polk P.O. Address Newberry, Fla Sworn to and subscribed before me this 27 day of November 1902. H. C. Denton, Clerk Circuit Court, Alachua County. Per S. H. Wienges, D.C. (Seal affixed) ************************************************************************ Page 008 1902 Granted Claim for Pension By $120.00 Sam Polk Of Alachua Co, Late of …………………Company …………………Regiment Filed in Executive Department Dec 15 1902 Approved July 25 1903 C. H. Dickinson Secretary of Board Filed in Comptroller’s Office 120.00………19.. Pay from Dec 15, 1902 At rate of $96.00 Per annum. Page 009 I do solemnly swear that I was born on the 15 day of November 1832 in Lownds (sic) county, State of Georgia and that I am now past the age of sixty-five (65) years; that I was a bona-fide citizen of this State on January A.D. 1885, and have continuously resided in this State since that date; that I do not own property, real or person, or real and personal, to the value of eight hundred dollars ($800), and that I am by reason of age incapable of providing a living by manual labor for myself. Sam (his X mark) Polk P. O. Address Newberry Sworn and subscribed before me this 27 day of November 1902. H. C. Denton, Clerk Circuit Court, Alachua County Per S. H. Wienges DC We do solemnly swear that we personally knew Sam Polk the above applicant for pension during the Civil War of 1861 to 1865, that we served with him in Dudley’s Company C 7th Fla Regiment, and know of our own knowledge that he did receive the injuries set forth in the above application at the time and place claimed, and that the disability therefrom claimed to exist, does exist, and that he never deserted the Confederate Army. James Darg Late of Co C Co 7th Fla Reg Geo. J. Arnom, A.Q.M. Late of 7th Fla Reg’t Sworn and subscribed before me this 27 day of November 1902 H. C. Denton, Clerk Circuit Court, Alachua County Per S. H. Wienges DC We do solemnly swear that we are familiar with the value of all the property owned by Sam Polk and his wife, directly or indirectly, in this or any other State, and that the actual combined value thereof does not exceed $800; that they have not disposed of any property for the purpose of availing themselves of the provisions of the pension laws of Florida, and that he is not physically or otherwise able, or in a position to earn a livelihood, by manual labor. S. S. Weeks P. O. Address Newberry Fla Charlie Matthers (transcribers note: surname could be Matthews) P. O. Address Newberry Fla Sworn to and subscribed before me this 19th day of November 1902 W. H. Tucker Notary Public (Seal affixed) Page 010 We, the undersigned physicians, residents of the State and county aforesaid, do solemnly swear that we have carefully examined Samuel Polk who is personally known to us to be the person above applying for a pension under the laws of Florida, and find that he has left inguinal hernia and rheumatism of the legs together with senile decay practically rendering him incompetent to earn a livelihood by manual labor. J. C. Bishop M.D. Residence Alachua Fla J. L. Cloud M.D. Residence Alachua Fla Sworn to and subscribed before me this 28th day of Nov. 1902. J. A. Williams Justice of Peace I certify that the above affidavits are genuine; that all the affiants are persons of respectability and good reputation, and that their statements are worthy of belief; that the attesting officers are duly authorized to attest said affidavits, and that their signatures thereto are genuine. H. C. Denton Clerk of Circuit Court We, the undersigned County Commissioners of Alachua county, Florida, do hereby certify that we have carefully investigated the above application for pension made by Sam Polk and are satisfied that the conditions and alleged facts therein stated are true and correct, and that he is legally and justly entitled to the pension provided by the act, approved May 3, 1901. T. F. Thomas, Chairman P. G. Ramsey T. C. Bryant E. L. Johnson J. G. Dampier County Commissioners By the County Commissioners. Attest: H. C. Denton Clerk Circuit Court REVISED STATUTES OF FLORIDA, CHAPTER II, ARTICLE I. 2077. The children of parents who are unable to support themselves, shall be required to make provisions for their support. 2078. On information filed before the Justice of the Peace of the proper district by any person whomsoever, stating that certain persons have made no adequate provisions for their father and mother, or either of them, the Justice shall cause a summons to be issued to said parties, and evidence to be taken as to the truth of the facts stated in the information, and if the same shall be found true, after a fair trial in which the defendants shall have the right to be heard by counsel, the Justice shall issue an order making an assessment on the said children for such amount as shall be necessary for the support of their parents. 2079. Said order shall carry with it the right of enforcement by execution, and shall have the force and effect of a writ of garnishment on the wages of such children, and shall further provide for the person to whom and the manner in which the money assessed therein shall be paid. Page 011 State Board of Pensions No. 17488 Governor Comptroller Treasurer Department of Pensions State of Florida Tallahassee, 9-25-09 Hon. F. C. Ainsworth The Adjutant General Washington, D.C. Dear Sir: Sam Polk who is applicant for a pension under the laws of Florida, claims to have been a member of Company C, 7th Fla Regiment Inft., Confederate States Army, and to have been…………………………………………………………………………………………………………………………………………………………………………………………………………………… …………………………………………………………………… Please furnish me with the record of this soldier. Yours very truly, W. V. Knott, Treas. Page 012 ADJUTANT GENERAL’S OFFICE 1572799 WAR DEPARTMENT SEP 30 1909 Address: The Adjutant General 6362 War Department Washington, D.C. Samuel Polk 17488 1572799 War Department, The Adjutant General’s Office, Washington, October 1, 1909 2861 Respectfully returned to the Treasurer, State of Florida, Tallahassee The records show that Samuel Polk, private, Company C, 7th Florida Infantry, Confederate States Army, enlisted March 20, 1862, that he was captured near Franklin, Tennessee, December 17, 1864, and that he was released June 13, 1865, at Camp Chase, Ohio, on taking the oath of allegiance. F. C. Ainsworth The Adjutant General [A.G.O. 72-1] File at: http://files.usgwarchives.net/fl/alachua/military/civilwar/pensions/polk6gmt.txt This file has been created by a form at http://www.genrecords.org/flfiles/ File size: 18.7 Kb