CULPEPER COUNTY - WIDOW'S PENSION APPLICATION: LUCY ANN MELTON Library of Virginia Images 228-230 Transcribed by Scott Harlow and submitted for use in the USGenWeb Archives. *********************************************************** USGENWEB ARCHIVES NOTICE: These electronic pages may NOT be reproduced in any format for profit or presentation by any other organizat- ion or persons. Persons or organizations desiring to use this material, must obtain the written consent of the contibutor, or the legal representative of the submitter, and contact the listed USGenWeb archivist with proof of this consent. The submitter has given permission to the USGenWeb Archives to store the file permanently for free access. http://www.usgwarchives.net ************************************************************ Image can be viewed on the Library of Virginia website: http://image.vtls.com/CP/html/03631.html Form No. 3 Application of a Widow of a Soldier, Sailor, or Marine of the late Confederacy Under Act of 1902, as amended. I, Lucy Ann Melton, do hereby apply for a pension under the provisions of the act of the General Assembly of Virginia, approved April 2, 1902 as amended, entitled “An act to aid the citizens of Virginia who were disabled by wounds received during the War between the States while serving as soldiers, sailors, or marines of Virginia, and such as served during the said war as soldiers, sailors, or marines of Virginia, who are now disabled by disease contracted during the war or by the infirmities of age, and the widows of soldiers, sailors, or marines of Virginia who lost their lives in said service, or those whose death resulted from wounds received or disease contracted in said service, and providing penalties for violating provisions of the act.” I do solemnly swear that I am a citizen of the State of Virginia, and that I have been an actual resident of the said State for five years next preceding the date of this application, and that I am the widow of William Amos Kilby who was a loyal soldier (sailor or marine) in the service of the Confederate States in the war between the States, and that, to the best of my knowledge, during the said war my husband was loyal and true to his duty, and never at any time, deserted his command or voluntarily ab-andoned his post of duty in the said service, and that I was never divorced from my said husband, and that I never voluntarily abandoned him during his life, but remained his true, faithful and lawful wife up to the date of his death, and that I am a widow at the date of making this application , and that I am now entitled to receive a pension under the provisions of said act. And I do further swear that I do not hold any position or office, either national, State, city or county, with pays me in salary or fees Two Hundred ($200.00) dollars per annum; nor have I an income from any other em-ployment or source whatever which amounts to Two Hundred ($200.00) dollars per annum, nor do I own in my own right, nor does any one hold in trust for my benefit or use estate or property, either real, personal, or mixed, in fee or for life, of the assessed value of Seven Hundred and Fifty ($750.00) dollars; nor do I receive any aid or pension from any other State, or from the United States, or from any other source, and that I am without means of support, either direct, or indirect; and I do further swear that the answers given to the following questions are true: All questions must be answered fully be explicit: [Original form had questions in two columns] 1. What is your name? Lucy Ann Melton 2. What is your age: Sixty four 3. Where were you born? Culpeper, Va. 4. How long have you ….. illegible) All my life 5. How long have you resided in the City or County of your present residence? 17 years 6. Where do you reside? If in a city, give street address Post Office Culpeper County of Culpeper 7. With whom do you reside? with my children 8. What was your husband’s full name? William Amos Kilby 9. When, where, and by whom were you married? Rev. Silas Bruce When? 8 Dec. 1867 Where? illegible illegible Culpeper Co. By whom? Rev. Silas Bruce 10. When and where did your husband die? 23 January 1916 11. What was the cause of his death? Lagripp-[?] 12. Give the name and address of physician who attended your your husband at the time of his death. Name: Dr. Tucker Chelf Address: Culpeper, Va. See Certificate “D” 13. Have you married since the death of your husband? If yes, give all particulars. No 14.In what branch of the army did your husband serve? Regiment “C” 7th Va. Infantry Company 15. Who were his immediate superior officers? Colonel-Capt- J C Porter 16. Give the names and addresses of two comrades who served in the same command with your husband during the war. Name blank Address blank Name blank Address blank See Certificate “B” 17. Give the names and addresses of two persons who are familiar with the circumstances of your husband’s death. Name blank Address blank Name blank Address blank See Certificate “C” 18. What maintenance do you do you receive, and what income have you from all sources? None NOTE: By income is meant the total gross receipts derived by you from all …….. (whether ….. or……..), wages, and other sources valued in dollars. 19. How much property do you own? Real Estate $ None Personal Property $ illegible…………………….. 20. Was your husband on the pension roll of Virginia? If yes, in what County or city was his pension allowed? Yes in Culpeper County 21. Have you ever applied for a pension in Virginia before? If yes, why are you not drawing one at this time? No 22. Is there a camp of Confederate Veterans in your city or county? Yes 23. Give here any other information you may provide relating to the service of your husband or the nature of his death which will support the justice of your claim. He was a prisoner of War in……. … ….. labor Lucie A Kilby Signature of Applicant I, W.D. Colvin, a Justice of Peace, in and for the County of Culpeper of Culpeper, in the State of Virginia, do certify that the applicant whose name is signed in the foregoing application personally appeared before me in my County aforesaid, having the aforesaid application read to her and fully explained, as well as the statements and answers therein made, the said applicant made oath before me that the said statements and answers are true. Given under my hand this 15 day of March 1916 W D Colvin JP Signature of Officer (A) OATH OF RESIDENT WITNESSES (Must be signed by two residents of applicant’s City or County) We, R. illegible illegible and illegible do solemnly swear that we are residents of the …………of ……….in the State of Virgiia and that we have known personally and well for ………years the applicant whose name is signed to the foregoing application for aid under the act of the General Assembly of Virginia, approved April 2,1902, as amended, and that the said applicant is a resident of the said city or county and is a woman of good reputation for truth and honesty, and that we have read the foregoing application and the answers to the questions therein propounded, made by the said applicant and verily believe that the said applicant has been truthful in the said statements and answers, and that from our per- sonal knowledge, we verily believe the said applicant is justly en- titled to aid under the said act, and that we have no personal inter- est in the allowance of the applicant’s claim. A Signature made by X mark is not valid unless attested by a Witness. R.J. Thrall J B Herndon Resident Witnesses Subscribed and sworn to before me, a justice of the peace in and for the County of Culpeper State of Virginia this 18 day of March 1916 W.D. Colvin JP Signature of Officer (B) AFFIDAVID OF COMRADES (See Question No. 16 on page one) We, William H Fray and H. C. Burrows do solemnly swear that we are residents of the County of Culpeper, in the State of Virg- inia and that the applicant whose name is signed to the foregoing application for aid under the act of the General Assembly of Virg- inia, approved April 2, 1902, as amended, is personally known to us and that we have known her for 54 years, and know her to be the widow of Wm A Kilby, who was a soldier (or sailor or marine) in the military or naval service of Virginia, or of the Confederate States, and that we were soldiers (or sailors or marines) in the said Service during the said war, and that we were with the said appli- Cant’s husband and members of the same command, and to our Personal knowledge, he died on or about 23d day of April 1916 From the effects of La Grippe and that he was a true and loyal Soldier in the said service and was faithful in the discharge of his Duty, and that we have no personal interest in the allowance of the applicant’s claim. A signature made by X mark is not valid unless attested by a witness W H Fray H C Burrows Comrades Subscribed and sworn to before me, a Justice of the Peace in and For the County of Culpeper, State of Virginia, this 18th day of March 1916. W D Colvin JP Signature of Officer NOTE- If only one comrade whose name is known to the applicant, let him make affidavit B. If no such comrade be living whose ad- dress is known to the applicant, then let one or more reputable persons who have personal knowledge of the services of the app- licant’s husband and of cause of his death, make affidavit C. AFFIDAVIT OF WITNESSES, NOT COMRADES (not necessary when Certificate B can be filled.) We. Fitz Lee Colvin, and …………. do solemnly swear that we are residents of ………, in the State of ……… and that we personally know, and are well acquainted with the appli- cant whose name is signed to the foregoing application, and who is applying for aid under the act of the General Assembly of Virginia, approved April 2, 1902, as amended, and that we have known the said applicant for …….. years and that to our personal knowledge the said applicant is the widow of Will- iam Amos Kilby, who was a loyal and true soldier (sailor or marine), in the military or naval service of Virginia, or of the Confederate States, in the war between the States, and that on or about the ….. day of 23 Jan 1916, the said applicant’s hus- band died, and that they lived as husband and wife up to the date of the death of said husband, and that we have no personal interest in the allowance of the applicant’s claim. A signature made by X mark is not valid unless attested by a Witness. Fitz Lee Colvin F. F. Collins Witnesses Not Comrades Subscribed and sworn to before me, a Justice of the Peace in and For the County of Culpeper State of Virginia, this 18 day of March 1916. W D Colvin JP Signature of Officer (D) CERTIFICATE OF PHYSICIAN Physician will please read carefully the answers to questions 10, 11, and 12 and the following certificate before filling out. I, H. T. Chelf, a practicing physician in the County of Culpeper, in the State of Virginia do certify that I am personally acquain- ted with the applicant, whose name is signed to the foregoing application for aid under the act of the General Assembly of Virginia, approved April 2, 1902, as amended, and that I attended her husband, Amos Kilby during his last illness, and that from my professional knowledge of the cause of his death, I verily believe that his death resulted from La Grippe and that I have no per- sonal interest in the allowance of the applicant’s claim. Given under my hand this 20th day of March 1916 H T Chelf, MD (E) CERTIFICATE OF CONFEDERATE VETERANS (Must be filled up when there is a camp in applicant’s city or county) I, H G Burrows…commander of A.P. Hill #2 camp of Confed- erate Veterans of the County of Culpeper in the State of Virginia, hereby certify that the said camp has examined the merits of the foregoing application for aid under the act of the general Assembly of Virginia, approved April 2, 1902, as amended, and being satisfied of said claim, hereby recommend the same, under the provisions of the said act, and that the said camp has no personal interest in the allowance of the applicant’s claim. H. G Burrows Commander NOTE- If there is no camp of Confederate Veterans in applicant’s city or county The certificate of two Ex-Confederate soldiers, well known and of good reputat- ion, residing in said city or county, must be obtained to certificate F. (F) CERTIFICATE OF EX-CONFEDERATE VETERANS (Not necessary when certificate E can be filled) (G) CERTIFICATE OF COMMISSIONER OF REVENUE I, C.H. Commissioner of Revenue in the County of Culpeper, the State of Virginia, do certify that the applicant (or her trustee), whose name is signed to the foregoing application for aid under the act of the General Assembly of Virginia, approved April 2, 1902, as amended is charged on the land and personal property books of the said County with estate, real, personal or mixed, of the assessed value of $ X Given under my hand this 25 day of March 191 Commissioner of Revenue The actual amount due or unpaid upon any deed of trust or mortgage to secure the payment of a debt shall be deducted from the assessed value of the property of claimants under this act. In computing the value of the estate held by any person or for his or her benefit, all property conveyed by deed for consideration not deemed valuable in law or ……… w….. gift since March 2, 1902 shall be considered as his or her estate. (H) CERTIFICATE OF PENSION BOARD I, J. H. Collins, chairman of the Pension Board of the County of Culpeper State of Virginia, do hereby certify that the foregoing application has been Examined and approved by said Board. In testimony whereof I hereto set my hand, this 1st day of April 1916 J. H. Collins Chairman of Pension Board (I) CERTIFICATE OF JUDGE This Court, from an examination of the foregoing application and of the affidavits, certificates, etc therewith filed, and hereto annexed, and of such witnesses as were required and called by the court, being satisfied that the said application is supported by the affidavits, cert-ificates, etc. of persons of well-known reputation for truth, honesty, and integrity, and that the claim of the said applicant is just, and in due form, doth certify the same to the Auditor of Public Accounts. Given under my hand this 17th day of April 1916 John Rutherford, Judge [ Lucy Ann Melton was a daughter of Richard and Minerva Melton. Her gravestone has her birth year as 1843 and death year 1926 (27 Aug.). Six of Amos and Lucy’s nine children are buried with them in the Fairview Cemetery at Culpeper, Va.] [entries written in bold italic represent the handwriting of the several persons]