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State of County of I,, Clerk of the Court in and for the County and State above named, do hereby certify that , Esq., before whom the foregoing affidavits were made, and who has thereunto signed his name, was, at the time of so doing, a in and for the County and State above named, duly commissioned and sworn; that all his official acts as such are entitled to full faith and credit, and that his signature thereto is genuine. In witness whereof, I have hereunto signed my name and affixed my official seal, this day of, 186. ,Clerk. No. WAR DEPARTMENT, BUREAU OF REFUGEES, FREEDMEN, AND ABANDONED LANDS. WASHINGTON, D.C. CLAIM DIVISION. CLAIM FOR ARREARS OF PAY AND BOUNTY Late a Co., Reg't U.S.C. Discharged , 186. Filed in the Office, 186. FORWARDED BY 1st. The claimant must state fully what he claims, whether pay, bounty, clothing, travel, &c., and explain, in regard to each item, why he has failed to receive his due. 2d. He must state whether he was with his Company, and, if not, where he was, upon each muster day during the time for which he claims pay. 3d. If he was in hospital upon any such muster day, he should particularly state the name, number, and location of the hospital, and the dates at which he entered and left the same. 4th. If he was a prisoner upon any such muster day, he should state when and where he was captured and paroled, or otherwise released, and where he has been since his release up to the time of his discharge. 5th. If he was ever court martialed during the time which he claims, he should furnish, if possible, a copy of the order restoring him to duty. If claimant has, at any time during his service, been charged upon rolls with desertion, he should state the circumstances attending the charge, and by whose order he was restored to duty - whether with or without trail. 6th. If the claim be for bounty under law of July 22, 1861, state whether the $25 advance bounty has been received. 7th. If the claim be for bounty under act of July 18, 1864, state the installments paid and unpaid. 8th. In claims for pay proper, the claimant should specify the months claimed, and, if possible, upon what rolls he was mustered for the same. 9th. If the applicant claims anything on account of clothing, he must, if possible, furnish the sworn statement of the commanding officer or the company to which he belonged, sustaining the claim. Few claims for clothing can be collected without such affidavit. 10th. Send the discharge always. If claimant has lost or failed to receive his discharge, he should send an affidavit, stating fully how he lost it, or why he has never received it, and giving the date of his enlistment. NOTE. - The foregoing statements should be embodied in claimants declaration, or if space will not permit, they can be sent in the form of a letter, addressed to the Second Auditor of the Treasury, except those which are specially required to be under oath.