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State of Tennessee, County of Warren
On this 30th day of June, A.D., one thousand eight hundred and sixty nine, personally appeared before me, a Justice of the Peace, within and for the County and State aforesaid, Polly Horton, widow of Isaac Horton, dec'd, aged 57 years, a resident of Warren County, in the State of Tennessee, who being duly sworn according to law, declares that she is the identical Polly Horton, widow of Isaac Horton, who was a private in the War of the Revolution, that she was married to the said Isaac Horton in Wayne County, Tennessee on or about the 12 day of May A.D. 1847, by one John Davis, a Justice of the Peace for said County, and that her name prior to her marriage with the said Isaac Horton was Polly Weaver. That he died on the 28th day of February A.D. 1855, in Wayne County, Tennessee, and that he was a Pensioner on the Roll of the Pulaski Agency and that the Pension Certificate has been destroyed as she verily believes but by whom she is unable to say. She makes this declaration for the purpose of obtaining the Bounty Land to which she may be entitled under the "Act granting Bounty Land to certain Officers and Soldiers, (and widows of) who have been engaged in the military service of the United States" passed September 28th, 1850 and also the act of March 3rd 1855.
Polly X (her mark) Horton
Attest: Sam Henderson
Attest: James M. Argo
Sworn to and subscribed before me the day and year above written. And I hereby certify that I believe the said Polly Horton, widow of Isaac Horton, to be the identical person she represents herself to be and that she is of the age above stated and I further certify that I am not interested in this claim directly or indirectly and that the foregoing declaration was sworn and understood by declarant before signing.
George T. Purvis, Justice of the Peace
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To the Commissioner of Pensions, Washington City.
Sir: I request that my claim to Bounty Land under the Act of Congress passed September 28th, 1850, be examined, and if I am entitled to Land, that the Warrant or Certificate therefor be sent to W. W. Ferguson, at Carthage, Tennessee, who I hereby constitute my Attorney in fact for that purpose and for my benefit.
Acknowledged before me this 30th day of June A.D. 1869.
Polly X (her mark) Horton
P. O. Address McMinnville, Warren
County, Tennessee
Goerge T. Purvis, J. P.
Attest: Sam Henderson
Attest: James M. Argo
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Proof Of Identity
State of Tennessee, County of Warren
On this 30th day of June A.D. 1869, personally appeared before me a Justice of the Peace in and for said County, Alexander Wright and Squire Hunter, whom I certify to be persons of veracity and made oath in due form of law that they personally know Polly Horton, widow of Isaac Horton, whose signature appears to the foregoing declaration, and that she is the identical Polly Horton who is the widow of Isaac Horton who was actually in the service of the United States during the War of the Revolution as set forth in said Declaration and a Pensioner and that they are not interested in this claim directly or indirectly.
Alexander Wright
Squire HunterSworn and subscribed before me the day and year above written, George T. Purvis, J.P.