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[[Underlined]]Application[[/Underlined]]
Pass Christian Miss Aug 12 1865
To Captain George D. Carpenter
Commanding Post- Pass Christian

Sir:
I, the undersigned, hereby respectfully make application for amnesty and pardon, under the Proclamation of the President of the United States, dated at Washington, May 29, 1865, to be allowed to take the amnesty oath, as herein prescribed, and to be admitted to all the rights and privileges therein granted. And I, the undersigned, state that I have done the following acts, and rendered the aid and services to the Rebel Authorities, in aid of the rebellion, hereinafter, set forth, and no others, to wit.

And I further state that—
    1st. I have not been a pretended diplomatic or civil officer, or otherwise domestic or foreign agent of the pretended Confederate Government.
    2d. That I did not leave a judicial station under the United States to aid the rebellion
    3d. That I have not been a military, or naval officer of the pretended Confederate Government above the rank of colonel in the army, or lieutenant in the navy.
    4th. That I did not leave a seat in the Congress of the United States to aid the rebellion
    5th. That I did not resign, or tender my resignation of my commission in the army or navy of the United States, to evade duty in resisting the rebellion.
    6th. That I have not engaged, in any way, in treating otherwise than lawfully, as prisoners of war, persons found in the United States service as officers, soldiers, seamen, or in any other capacities
    7th. That I am not, nor have I been, an absentee of the United States for the purpose of aiding the rebellion
    8th. That I am not and have not been, a military or naval officer in the rebel service, who was educated by the Government in the Military Academy at West Point, or the United States Naval Academy.
    9th. That I have never held the pretended office of Governor of a Sate in insurrection against the United States.
    10th. That I am not one of those persons who left their homes, within the jurisdiction and protection of the United States and passed beyond the Federal military line into the pretended Confederate States, for the purpose of aiding the rebellion.

Transcription Notes:
Things I could not read marked with [?]