Soldiers Application for Pension: John W. Costine, Polk County, Florida File contributed for use in USGenWeb Archives by Jennifer Marie Sherrouse, jennifer@sherrouse.com USGENWEB NOTICE: In keeping with our policy of providing free information on the Internet, data may be used by non-commercial entities, as long as this message remains on all copied material. These electronic pages cannot be reproduced in any format for profit or other presentation. This file may not be removed from this server or altered in any way for placement on another server without the consent of the State and USGenWeb Project coordinators and the contributor. *********************************************************************** A photocopy of the original application can be obtained from the Florida State Archives http://www.dos.state.fl.us/dlis/barm/PensionIntroduction2.htm *********************************************************************** APPLICATION FOR PENSION UNDER LAWS OF FLORIDA ========================= [FORM A] FOR USE OF APPLICANT FOR PENSION ------------------------- I, John W. Costine, do hereby make application to the State Board of Pensions, for a pension to be granted me under the act of 1907, Chapter 5600 of the Laws of the State of Florida, upon the following grounds: I enlisted and served int he military service of this state during the war between the States of the United States, and that I did not desert the Confederate or State service; that I was a bona-fide citizen of this State for ten years prior to the date of this application and have been continuously since a citizen of the State of Florida, and that I (Here state fully the disability under which the applicant claims a pension, whether he lost in service a limb or limbs, eye or eyes,, or whether he is permanently disable by reason of wounds received in service, or disease to gain a livelihood by manual labor, or whether he is over 60 years of age and is by reason of age incapable of providing a living for himself.) am 79 years old in 7 May, 1908. I am aas feeble as that age will naturally make a man and am almost entirely blind in both eyes. I am totaly unable to make a livelihood for myself or my wife who still lives. I further represent to the State Board of Pensions, that I am not receiving a pension from any other State. In Witness Whereof, I have hereunto set my hand this Eighteenth day of Sept, A.D., 1907. Witness: [can't read signature] [signed] John W. Costine (John W. Costine) Postoffice: Morse, Polk Co. Fla -------------------------------------------------------------------------- (FORM B) STATE OF FLORIDA, | Polk County, | On this 1st day of October, A.D., 1907, before me John Patterson in and for said County and State, personally came John W. Costine, who being by me first duly sworn deposes and says, that the statements made in the foregoing application for a pension in his own behalf are true. This deponent further says, that the answers written herein to the following questions, numbered from 1 to 12 inclusive, are true: 1. What is your full name, and where do you reside? John W. Costine, Morse, Fla 2. In what State and County were you born and when? State of South Carolina, Colington District, in 1829. 3. How long have you been a citizen of the State of Florida? 50 years. 4. When and where and in what organization did you enlist during the war between the States? 1863, Polk Co. Jno. T. Lesley's Co. 5. Give the name of your Captain at time of your enlistment. Jno. T. Lesley. 6. Give the name of your Captain at time of your discharge from service. Jno. T. Lesley. 7. Give the name of your battalion or regimental commander both at time of your enlistment and discharge from service. Co. C C.J. Munnerlyn's Battalion at close of the war. 8. If you enlisted in the navy give name of your commanding office, date of enlistment and place of service. [blank] 9. If discharged prior to the termination of the war, state place and cause of discharge. [blank] 10. If you lost an eye or limb during your service in the war, state when and where and in what engagement your sustained such injury. [blank] 11. If you received a wound during your service in the war, which permanently disables you, state when and where you received the wound. [blank] 12. Describe the wound and state how it affects you. [blank] Sworn to and subscribed before me this the 1st day of Oct. A.D. 1907. [signed] John Patterson, Jr. | [signed] John W. Costine, Applicant. Notary Public | Postoffice: Morse, Fla. State of Florida | ============================= [FORM C] Affidavit to be Made by Commissioned Officer STATE OF FLORIDA | County of Hillsborough | Before me personally came Jno. T. Lesley, who being duly sworn deposes and says, that he was a Comissioned Officer in Col. C.J. Munnerlyn's Battallion, CSA the organization to which the within named applicant for pension under the laws of Florida belongs and in which he served during the war between the States. This deponent further says that the said Jno. W. Costine rendered faithful service as a Confederate soldier or sailor during the war between the States, and that the disability claimed by the said Jno. W. Costine [the following is scratched through] to exist, does in fact exist and the same prevents him permanently from gaining a livelihood. Sworn to and subscribed before me this 24 | [signed] Jno. T. Lesley, Captain day of September | Late of Col. C. J. Munnerlyn's A.D. 1907 | Battallion, CSA (This affidavit to be made by one who was a Commissioned Officer, and the blanks MUST be filled out.) _________________________________________________________________________ Certificate of Clerk of the Circuit Court ---------- I certify that the above affidavits are genuine; that all of the affiants are persons of trustworthy character and their statements are entitled to full faith and credit; that the attesting officers are duly authorized to administer oaths; that their signatures are genuine, and that the said applicant John W. Costine is a bona-fide resident and citizen of the State of Florida. In witness Whereof, I have hereunto set my hand and affixed the seal of the Circuit Court for Polk County, this 7 day of October A.D. 1907. [signed] A.B. Ferguson Clerk Circuit Court. ________________________________________________________________________ Application No. 10404 Pensioner No. 6424 ====================== CLAIM FOR PENSION By John W. Costine Of Morse Fla, Postoffice Polk County LATE OF [can't read] Company [can't read] Regiment ====================== FILED IN PENSION DEPARTMENT Nov. 7, 1907 ====================== APPROVED Feb 8, 1908 With pay from Nov 7, 1907 At the rate of $120.00 per annum [signed] Jefferson Bell Secretary of Board __________________________________________________________________________ SOLDIERS PENSION CLAIM UNDER THE ACT OF 1909. ========================= (FORM A.) STATE OF Florida | County of Polk | On this 4th day of September, A.D. One Thousand Nine Hundred and Nine personally appeared before me, a Notary Public in and for the county of State aforesaid, John W. Costine, who, being duly sworn according to law, declares that he is 80 years of age, having been born on the 1st day of May, 1829, in the county of Colleton District, in the State of South Carolina. That he is a bona fide citizen of the county of Polk, State of Florida. That he has resided in the State of Florida continuously since the ___ day of about January, 1851. That he is the identical person who enlisted at on Alafia River, Hillsboro Co. Fla, under the name of [blank] on the _____ day of April 186_, in Company Jno. T. Lesley, Regiment Mounted Company, Munnerlyn's Brigade of the State of Fla in the service of the Confederate States of America (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 Tampa, in the State of Florida, on the __ day of April, 1865, on account of Surrender of General Lee's Armies (Here state fully any other military service performed by the applicant.) I was under Capt. Lesley and performed such service as he directed. My service was principally in South Florida. (Applicant is not very vigorous, mentally, but says his record is on file in Tallahassee.) (Here give date and place of capture, imprisonment, exchange or parole.) [space is blank] That I served faithfully until HONORABLY DISCHARGED from the service of the Confederate States in the year 1865, and did not desert the service of the Confederate States 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 at home on sick leave, suffering with rheumatism, but my Discharge was as of Tampa Bay. 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 won 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, 79 acres real estate, value about ..$ 500.00 Cattle, horses and other live stock..............$ 100.00 Personal property................................$ 100.00 Stocks...........................................$ ______ Bonds............................................$ ______ Mortgages, notes and other securities............$ ______ Total.................$ 700.00 That I have heretofore been granted a pension from the State of Florida under pension certificate No. 6424 at a rate of $120.00 per annum. (Here state any disabilities, physical or mental.) At the age of nearly 81, I am very feeble, and practically blind, requiring the assistance of other to lead me around. (Here state any wounds received, or loss of limbs and eyesight.) Nearly blind. That my postoffice address is Auburndale, County of Polk, State of Florida. [signed] John W. Costine, signed by ?? at his request (Claimant must sign name in full.) Attest: (1) [signed] J A Voyles (2) [signed] John Harris Sworn and subscribed before me, this 4 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 have no interest, direct or indirect, in the prosecution of this claim. [signed] H. J. ?? Notary Public The Notary would specially call attention to the fact that the foregoing statement as to physical condition is not overdrawn. The applicant had to be assisted in sitting in a chair, as he could not see the char. He is exceedingly feeble and can only live a few months, at best. He is a fine old citizen and a most worthy man. [signed] H. J. ?? Notary Public __________________________________________________________ (FORM B.) STATE OF FLORIDA, | County of Polk | We, the undersigned citizens of Polk County, State of Florida, do hereby certify that we personally know John W. Costine, 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 the property of his wife) to exceed in value 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.) [signed] J. A. Voyles [signed] John Harris Sworn and subscribed before me, this 4th day of September, 1909. [signed] H. J. ??, Notary Public ======================= (FORM C.) Physicians Affidavit. STATE OF FLORIDA, | County of Polk | Before me personally came W. R. Groover, 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 John W. Costine 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.) No wounds. Extreme old age and infirmity. Practically blind. This deponent further says that the said John W. Costine is permanently and totally disabled by reason of such age and loss of sight from earning a livelihood for himself by manual labor. (Please note carefully resolution below before certifying to total disability.) Sworn and subscribed before me, this 4th | [signed] W.R. Groover Day of September, A.D. 1909 | Physician. [signed] H.J. ??, Notary Public At a meeting of the State Board of Pension 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. _______________________________________________ Report of County Commissioners. We, the undersigned, County Commissioners in and for the County of Polk State Florida, do hereby report that at a meeting of the Board of County Commissioners held this day, the foregoing application of John W. Costine 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 7 day of Sept. A.D. 1909. (1) [signed] J M Hooker (2) [signed] J A Durance (3) [signed] E. S. Whidden (4) [signed] E.J. Yate (5) [signed] T.A. Currie County Commissioners By the County Commissioners, Attest: [signed] A. B. Ferguson, Clerk Circuit Court. NOTE - All blanks must be filled out. All information required must be fully and accurately given. ________________________________________________________________________ Former Claim No. 6424 Application No. 16821 Pensioner No. 5241 ====================== CLAIM FOR PENSION By John W. Costine Of Auburndale, Postoffice Polk County LATE OF ____________ Company Fla Regiment ====================== FILED IN PENSION DEPARTMENT Sep. 11, 1909 ====================== APPROVED Feb 15, 1910 With pay from July 1, 1909 At the rate of $120.00 per annum ____________________ Secretary of Board __________________________________________________________________________