New Britain Herald Newspaper, July 5, 1924, Page 10

NEW BRITAIN DAILY HERALD, SATURDAY, JULY 5, 1024, INSTRUCTIONS RELATIVE TO ADJUSTED COMPENSATION fi-hand side of the application ' fiohand side of the title, shal n conyiction |t 4 do Not remem i ' were inducted | For the purpese of expediting the any s 2 fling of | f. be fined net more 41,004 ) Ee AN ARSWOR, WP A éd, the date on W [ s in g of applications for adjusted \ ient for net mers fiie years, N othe space previded were enlisied (not the date you w application compensation by ex-servicemen, the od for enlistement), 1f dou w Tren This ftem will not be flied in all Inw ally betore| N is aliowed far time sersed under [ servist or an officer of thet Reser when & dependent (s making application 1 O Whith yeu Siarted . Persons who withess the signas Herald is today publishing in abbre ' " sllowing headings give e APRIVANL SN 10 the space Do viated form the blank which it win ni od officer abare the |y e order calling y 1o A A e o) aplican o fill o1 ' A ain in 1 Army or Marine | dut % den't know f o A T #gnutire, they will assure be neceasary for applicants to fill out L 10 1he Navy. (iret lieutons |18 any doubt, thew sive das o 'wi emselves Lhat the veteran who slgns t The important questions to be .mv| in. the L DA st leutenant of Engineecs in the [order directed you fo repart; Af meit pidenie 1n Mew 10 18 VEeRticA) Witk the sawered will be found on this page 1egula 0 Adiusted $L Gluard, pussed assistant surgeon in |these dates is avallable, wive date » 4 M oith ih o Ex-servicemen should go 1o the | ompensation » . ression “mill Publio Health Nervice % tally teported for duty. 1t you v Bllsastn, U alen onttety, thom give the correct answers to these |« iudes seriice I Coast Guard and Mas| (2) liolding & permanent ¢ avisional [dent, 1f the origing) entry iute We SN Wil on ) Abs yoltren tie questions, 1t would be advisable'to Carpa unless otlierwise specified Mmission oF permanent or warrant | service was in status of & comm S SITRIVIAS S AW fur. Y In these instructions whereser the term |in an " of the or officer, eare \ Nat Il In the blank as published here. | waal folr P& reserve or fonal G wses Of the Witnesses mus iven | all i e K ¥ - 11 1egal gunrdian’ ‘or “lewal gunrdian of vet. |forces ar ile Nolding such commission or |officer, give the da acceptance of g . e ol | with so that the answers may bo read |, o used, It includes and pertaing to | Warrant) & under a temporary come [original commission and not the date of | Tiems 1, 2 and 26 are to he off at the time of Aling the applica- guardian of the dep ne alm mission In a higher grade, 1n each cuse for [commission, If you were enlisted or lnducts | used only In <& 1 NaLNt e kin tion ur appication from the tnfors | "¢ perie ’1‘0‘ service under mucl conmission |ed, and later comniiasioned, the date i+ [apniication for pmpensation, 4 Saa arviee TBuroau, on the on your discharge certificate or 4 | OF WATTANt ot in sy gher grade after (Binal entry Is the date you were enlisted | Item 1—Tn ¢ tom give the Naines, h'l" "ll m: )l' r lr| n’“»r|“ 4 te in 1oy of Most or destiaved din |10 avcrual of the right te pay thereunder, [ar inductad and net date of commig: | Addiesses and, n of chil) or ehildren third fleor of the city huilding, will b wicate, it possible, bur, At you | T8 subdivision dees not appiy to amy nons |sien, In case you entered the service twice | 1o date or dates of hivth, of all persons open from 10 a, m, to 6 p. m, he. er With you. do mot delay yeyr | 'OMMissioned offive [after April 8, 1917, or before November 12, | of tha indicated relationship who were des ginning Monday Evening sessions |awn other cases by writ otk | BT \-‘. civilian afficer ar emp! 1918, and your service was not continusus w‘hl\-m "n n“ vetaran ut the time of his pep e ara " ficate in len, If you do not ha Ain | AN branch of the military or nava | &ive dates of hoth inductions or entistmenta, | 4eath. In order to he entitled to compens will be held after next week The | ian tortificats or n vertificars i fee" [contrace surgeon, cadet of the United Sates | An exampla of the Intter case is whei & |8t1on under tho provisions of the World fling of applications In boing cared [, (60 4 CTC T 8 e “anplication | MUIARY “Academy, widshipman, cadet or |Wan was in the service on April 6, 1917, | \WAr Adjusted Canijiensation Act the des for by the bureau in co-operation with |Liank from memors to 1 best of your (A0t engineer of the Coast Guard, mem. (And discharged subsequent thereto an Kurs [Ve0doat must huve heen dependent on the 4 . | | hera of the Teserve Officers’ Training (‘o con's Cert) of Disablility, and Iate eran at the time af sald veteran's deat the American Red Cross and the ex. [ability, But, In any case do not write 1 ra' Training Corps, | & U Isablili nd later |2 ° d ) 's 0 | member of the Rtudents' Army Training | Inducted and accepted for limited military |} €A% 0f mare than oue dependent At the servicemen’s organizations, oA v atarny pamartments, iarine ¢OrMA | Corna envent snilsted men ‘detailed. therer | 861vice [time of the veteran's death, they nre ens The following statement has boen ey or for information telative to your dise |7 TIIIPPINe keaut, iember of the Philip. | Item & YO0 werd au enlibtad man, |41 04 18 cymineusation fu the following or fssued by the government in connecs |charge : | pine Guird, member of the Philippine Con. | &1ve 1 ou were separated from the |4eTi (1) Widow or widower, 1€ unmarried; 4t stabulary, member of the National | enlistment I ‘whiel were seiving on chiidre ) ‘mother; and ( Ather tion with adjusted compensation ap-. | tilind 1o UTeR wered and a1l f o iawaii, member of the insular forea of | November 13, 1915, unless honorably ise | VAL 1% suppasing eternn at the time e lications T led |y n se you do not remems |, . | . In death had a hild under eighteen and Plications: . her wpecific dates and linve not your dis. | (o N1Y. member of the Ramoan N [ etve fiate. You wera Sejnrated fram'the |41% '+ mother dependent uhon him . GENERAL Warge certificato or n cortificate in lieu | omrd ANd band of the Navy or Indian | K1V the d8te xou wers aeparated from 06 [ e\’ sippart, then the ehild would ba ens (Extract from Title VII, World War Ad.|®vaillable :Im:‘w o anproximate antes 88 | 0 A0l (ndividusl entering 11 i men who did" not veceiva a dischavge vorti- 111151 10 the Adjusted Compensation, or if justed Compensation Act.) ou remeniher then N case any item doen | . 0 J entering the military | g e " init a conslderable e ettt 8 widow and several children, the lor naval forcen afer November 11, 1915, for | [N A0 U UNiderable tma after 20U |\ iqaw wautd he entitled to the hencfits un g sl Autene | MOt ADDIY to you and the answer v mot | oh. 167t the servico, give the Jate you left the Fenalty for making false fraudulent | cavored in the Instruetions for that partics | "™ PeFlod after such entrance RS e arvies, XS 110 WACK Sau. {0tk r the Act provided she had not remarrie statement in application, ular Item, draw s line In the spare proei (5) Any commissioned or warrant officer | Mon i e’ the dute of the discharge o the death of the veteran in whicl Rec, 702, Whoever knowingly makes any | for the anawer ta that question, This fs | o O/MINE home ser not with tr0ona | “fram 6--ann out the words that do not | 4% it Would g (o the ohildren, Bo sure faise or fraudulent atatement of a material [uecessary o that it will ha known in the | 1y C 01 INE commutation of quarters or lappis ta sour cane. % cracn serice meann |17 EIVe the date or dates of birth of an fact In any application. certiticate or doru- [ offica acting on the applieation that no | *002stence rvicw on shore in Eurnpe, or Asia excius | 111ren who mighit have heen denendent on nient under the provislons of Titles 111, |items on the blank have heen overinoked |get betrs NI MET OF the Tubiie Wealth [aive of China. Japan and the Philipping 1a. |16 YOtrAn at tha time of his death 1V, V. of VI, or of any regulation made un- | by the applicant, 1f a certain itom applies Ite for any period during which he was {lands, Service in Siherin and the Archs |, 1100 22=In tha space after the word pot Jdetailed on duty with the Army or [angel Expedition counts as oversea service, €' In the firat line of this ftem Inmert [y 0 rmor industrial fur- |nnd Alnska does not count as being foreign | O™ FUth A Cwidow aRAn e To the Secretary of War or Secretary of the Nayy, [tough. aryive, & TOTEIBN fmiother, ar “fathier”, an tho caso may be : ’ () Whtle detailed for wark on rouds or | Item 7,-In t} o 4 the blank space afier “was’ insert ye 2oe rk on ronds o m 7 this ftem enter the name Adfuse following statements aro made by me in support ot my claim for |ather eansirurtion ar yenair. werk for (g | 116 arkanizin ey £ ae® of |age at (1o time of the death af tho seteran, justed Compensation under the provisions of the World War Adjusted [porled durdag which his pay ‘was equalized | the iasels an which you were stationed Ttem 23<A depondent must give the ad- Compensation Act: to conform to the compensatin ald te |With dates in either cese, 1f sou did net | Aress of his or her prosent residence. Fol nenantion paid 1o 4 did not | p civilian employees in the same or like em- | PPlong to an arganlzation or were detached 8 ¥ the Instructions under ftem 2 relative 1, Name of veteran: Horvice or ployment from vour ousAt, give the name of the sta- |10 the address to be gloen, The address " (9) Anv person discharged or ntherwise | 1ON 8t Which you Kerved, If you were sent |Under {teni 23 must be the eame as that released from the Araft, for any per T1th a hospital away from your own ergani- |€/ven under item 3. This nddress must be ft, for any periad o ¥ 5 NOoevviivviaun [mervice terminated by a discharse or relense | ZAHON, EIve t1a name or names of the has. | (7rrect so that the Departments or Bureanus (Last) (First) (Middie) from the draft CRATEE OF TEOAS® | italy'in whivh vou were. In case' of men |(lATRRA with acting on sour claim may Present address of veteran or dependent ..., 0 AR If rou come in any of the following |B"INE oversen for service ashore und re. |communicate with vau, If necessary, and so G ANE B [turning to the United States, do 1ot give [1hnt your Adfusted Servico Pay or Adfnsted classes, dn not subhmit an pliratio he (House No, and street) AU o Indlvidaot L A Application, he- [(he yamy of vour transport as a vessel on | Earvies Cortificate, It vour claim I8 Approv- ! Individual falitng. in any of these [whick you served, The onls votereny o or notification af disnilowance in cage it N groups is entitl ¥ compensation te) whatsoeter unn|~:dvh:v" r'l“n"nml "ot World | FIve the namu of a vessel i this item are |!* not aliowed will rench you as eoon as Moy mosver undar the prov "o otld | those whose service was in the Navy or |1rossible P ation arc riembers of the Army or Marine Corps as- | - Date of birth of veteran ..... o5 N at (1) Noet a member of the milita or [ signed to duty on a vessel or trans val forces of the United States at any | 7 v ¢ Ll # (Month) (Day) (Year) -(City) (State) |time ntrer Anri 5 5ot b Moty [fse there la not sufficient apace under this | Irall Family R : Original entry into World War service in the Army, Navy, Coast Guard, (12 1918, and whose to "f :'-"”.' hf””m s 'fl: ””flm e imin f pyatus 8 LY eunion olvi i les iv or Marine Corps D T e ity e, (oAl give Cheglelnnce wndesSBAmarkey niiem | Held in Collinsville Mrs, Calvin Coolidge and Mrs. Charles G. Dawes, wives of Y 5 (2) Separated from the seriice under (ganization, station or vessel. If you do mot the republican candidates, are photographed together for the first other than honorable ronditinne remember e exact dater, give the approxl- | A mathering of the Hall family was | ¢ (City) (County) (Sta L R P R P crrriireieseseises | (3) Conselentious objectors who perform- |niate dates. . 7 £ 2 (Rank or grade) (Month) (Day) (Tear) |ed no military duty whatever or refused to | Item &.—Give the charactor given on your |00 Yesterday at the old homestead WoRE: s it HiTor Ay the criaractor glven on your | in Ciollinsville. It was the first reunfon (4) Any allen discharged from the mill- |cer write “Officar™ fn the space provided |Of the family to be held in several taty or naval forces herauss of Allenage, | f0r Charactor, as mo tharacter was retord. |years, The home and grounds sere Personals Bursting Cannon Badly ()" Wa Brkorg i (nrlig d on officers discharge certificates. at i Mare workers, including the [ed on officors' discharge cortificates. prettily decorated in flowers and Injures Willimantic Boys Date of separation ....ovveiiiiiieiniiiiina., R RN Y ! (Month) (Day) (Tear) mercian Red Cross and officers thereof, Ttems8.~This item will be filled out only (6) Entire servica in any one o by men whe wers in the Marine Corps when | tables set on the lawn. The festivities r nore . Willimantie, Conn., July 5.—Leslie I did (did not) have ovemssea service. £ th of the classes enumeratad in the preceding |10y sailed for oversca duty or when they | continued throu, e day a Service in organizations, at stations or on vessels in the order named as |Paragrapi. Preceding | oiined to the United States. T¢ 3on were | Continued hrough the day and &1 . "y My Charlés Price and ‘ter, 18 years old, of 61 South Park follow: Attendance at an officers' training camp, | /7 the Marine Corpa and hed no oversea bountiful repast was served. 2 uniess Alrendy & memmer ot tha o CAMD. | oty “write the werd “Nonet nfter the | The following members of the fami- nRvAl forcos, is mot constdered as compens | ¥OrdA “Servize en in this item. Tf you [y were present: Miss Lina J. Hall, ‘ fablo mervice and consequently no henefits | hio o CTIOR Rervica bo wire to ehe the |y U "0 Hugins, Mr. and Mrs, |t Momauguin. jured yesterday afternoon when a of compensation accrue therefor duri el BMENSCEe LrANBDARS TdRLes ARl o et S Higis i —_ s - 3 r g e s%a50wenee SHOM. 4o nerind & veteran might have been 15 i |MAMES of ports of embarkation and de- | Harold Hugins, Mr. and Mrs. Basil mall cannon they were loading ex tendunce: barkation. Parson and Mrs. Charles H. Hugins, | Mrs and Mrs, James J. Bonney and | ploded. The cannon had not been used | = f ! Item 10—The benefi-iary named by you 7 % % . Ry a v anc . a5 arter i " S Ao e Instruction for Diependents Making Applica- [ this item docs mot hate 1o bo tie same |all of Collinsville; Mr, and Mrs, daughters, Helen, Annamay and JSL FeQIl, CAEtet WA 1301‘“"\”',‘" tha tion For Adjusted Compensation |a% tha one vou named in vour appleogn |James 8mith, Windsor: Mr., and Mrs, |of 45 Beaver street, spent yesterday barrel with his hands and McNichol 8. Character'given on discharge certificate ....................... Acdenendent making application for Ad. | for War Jtek Insurance, not the nearcst [\ (1 Jrench, Bloomfield: Mr. and |Momauguin. was pounding in the charge when a Justed ‘Compensation under the provisions |1{1Ative whose mame you zave at entrance | u &5 G ERER (o 00E AL L SO spark ignited the powder. The barrel Item 9 will be filled in only by men whoee service or part of whosé nv;r\'lcé of the Warld W i 1 e Vorld War Adjusted (: eatian linto the service but may be any person > , ama tusted CompensaUon yhom you desire to recoive the henefits of Towksbury, Middleficld: Fred and | James E. Thompson of New York |of the cannon was fih,n'irni The fin- trers of Carter's right hahd were frac- was in the Marine Corps. Act will use the same form that a veteran 18 | your Adjusted Service Compensation in case | o ppy Hall and families of Elmwood; |City is spending the week-end at t 5 1. tured and his thumb was blown off, 9. Embarkecd for oversea service on ................. ATaneS At uses in applying for benefits under the Act 3 v [ (WWEC Form No, 1), ‘In addi of your deathi. The relationship must be | H f e (Name of vessel) (Date) - 0. 1), “In addition the de- | joay i the space provided for the same, | Mrs. > Nettie Hall, Michigan; Mrs. [home of Mr, and Mrs. William J. Sul- His Joft arm was lacerated. Pleces of A pendent {5 required to make a supplemen- [y casa you desite to name a fulend as vaur | 1 R . UG isiin on vy BN AIBEMBRFKEd 11OM oo vivin v voresalniss '~':”~;":.(,",',"?;l o yered In items 21, 22, 23, | jonefistary, write “Friend” in the epace I‘m:: ' ,l I,\- I");o ,‘,U g: Fleln Ot o008 St O GLRREL the ‘flying metal pierced McNichol's (Natas. ot DorD) {(Name ot vessel) | Dependants sonric iopucation bani, |provided for. relationship, [he signature [ Earet and ‘Carol -Dix, Mr, and Mrs, = chest and punctured a lung A By (g hendents applving for benefits under |given in this item must be identical with | Howard R. Alderman and Mrs. Eatel- |y and Mrs, Georze Cooper and | ¢heet an 4 Wesacresnananrionsay BLoasinaiiaaieeioii, 00 return to Unitea (1€ Provisions of the World War Adjusted |th:e aignature to the certificate in item 19. [1a A, Alderman, all of New Britain SR £ Henry street, Mrk IR O RN (Date) (Name of vessel) Compensation Act -must furnish properly | Jtem 11.—In the rertangle set nff an the a2 2 : ain. {ganghter Helen, of Henry street, Mre. 19 Year Old Danbuty Sateh frdin Gerets sarvice: Juthenticated death certificate of the vet- |left-hand side of the application blank, un- gl Biizabeth Beebe of Hartford, Mr, and | 1¢ a8 1 anour) an on whom they were dependent, except |der this ftem, the applicant will make his Mrs. W. Phillips of Henry streat and | Youth Revolver Victim { Danbury, July 5.—Milton Willis, 13 Ttem 10 will not be filled out in case of dependent making application |in the case of a mah. who died in ti I i S 1 I A L L d he mili- | (her) fingerprints. y rati cGrath of Beaver siree 10. In accordance with the statements made by me in this application, 1 ;“'m"" naval l-;r\lwa If the dependent {s| Item 12—In completing item 12 either use (ommunm (‘eleblatlon Miss Betty McGrath of T ?\ r street, e her or mother of the veteran it is re- [a typewriter or print rour answer plainly, oY , H {spent the holiday a Lake Cong veayp Vi i e 0 R 3 on q so e hereby apply ror‘n} henefits to which I may be entitled under the |quired hy faw that a sisemens ot LRl L T R L Marred by Accident |7 T 2 vear old son of Nathaniel Willis of provisions of the World War Adjusted Compensation Act. and desig- |ency, under nath, he submitted as provided |vause this part of the application will be'a | Nopwich, Conn., July 5.— A commu mond, ) Broolkfield, died last night while be- nate the following-named person as my bencficiary under the pro- |in items 23 and 26 of the apnication. 1Art of sour record in tho Veterans' bureau, | GO N PO G S BT g e ing taken to the Danbury hospital Vilond oF Kaiq. act: ”AA;“:Td‘l’: this act the term “dependent” | @) The name given in this space must “: S l" _‘”" r"’" "k th ourth J“"xs' Jack Price of Washington &treet afier he had been shot in the head. o 0w or widower if unmarried, a the name of the veteran, regardless [ Night with fireworks was marred by » holiday at Momauguir i any i v |ehild or children, a mother, or a father, In | whether the veteran, a legal guard e Dremo ’ g oo spent the holiday at Momauguin. is in company with friends were \ in the premature explosion of a bomb = Fiii5 & TVelver Whish tHeY didisist siogpienain el bhe - order: Hanieds ian of the voteran, a dependent or lagal i ps which shot big spinters of wood Herbert 8. Dechant spent yesterday know was loaded. The gun was dis- (Mr., Mrs, or Miss) (First) (Middle) tLast) | A child of the veteran I8 presumed to guardian of the dependent, s making | 4 iave been dependent on him at the tims| _pplication, through the arms and legs of Paul |, \woterhury and New Have chorged and the bullet entered the | of the veteran's death, if at that time such | (b) In this space give vour serial or | Brown, 21, one of the amateur assis- 3 | - |young man's head. i L R R PP children, Vivian and Ruth, of 15l lgtreet and Arthur Mc Nichol, 28 of Washington street, spent the holiday |8 West I'ark street were seriously in- (Relationship of beneficlary hild was under 18 yenrs of aga, The term| f°rvic: number, depending on whether , i - 7 P ) o your service was In the Army or Navy, [tants at the display. He was badly Oscar Johnson and family of 212 “tlu,l’ll"; includes (1) a legitimata ehild; (2) i f i Wirnad absutiha # A hdaq 1 e y a child that had be v te & n case you ware never given a serlal [burned about the face an ecad and YA ey et SRR o S S 8 hosp . apend the week at Grove Beach. Through a typographical error it (House No.) (Street) (City) County) (State) the veteran's household; (4) an fllegitl- | provided for the number, If you are a 4 depeident making application and do e — was announced in Wednesday's Her- ; % mate child, but as to father only, if the fii el L BT L : Signature of veteran .......... oo coo(child bad been ncknowledged in ' writing PRI GO bl GIRL SOOUT NEWS Miss Irene Mectiellan of 151 Wash-1aid that the July Clearance sale of - signed by ¢ Ak H i pac A ) / WaEly : ¥ Cles (First) (Middie) A de"'m,'"""r';:n 'm"'_"""‘:_”',:"mrn':;_u provided for gerial number, | Wednesday will be moving day for ,ington ‘street will leave Monday for | Davidean & Leventhal's, which open- 13. See instructions for this item. child’s support, or if the father had heen | Nead eun ,',’,':Z,",;”’,: ,l'm',“,:m‘g"’_""\:,;;fl;'f lthe New Britain Girl Scout Camp |New Hampshire where she will spend | ed today, would continue for ten davs 8. c: :rlc‘d s o) h Hiaie i " ;1;;‘]!40!!1 to be the putative father of the tion write “'Decensed” In the space pro- | leaders. Camp will open Saturday, (the summer months. enly. lans have heen made to con- i i g HET S o The. Widew. ae. Meidswar st the votsran-d vided for the veieran's address, July 12 and many girls are anxiously — tinue the sale during the entire o of the veteran is a is -apace will he ere ¢ 4 i o y " 3 4 AT % eeieriieres.s |CONBIdered to have been dependent on mim | < date ane inee et Mn ot the eoetne | waiting for the date. A float is being | Mr. and Mrs, Harry Bonney and | month of J -advt. 14, I was commissioned or warrant officer performing home service not |{n,"th o (heir showing that they and Fegirdiess of who 1s making application, |built and water sports and instruc- children, Milton, Ruth and Robert of with troops and recciving commutation of quarters or of subsis- |and wife at the Hm: :::‘C:;::rw,:-:er'::\”; ’nvlm:"\:mr';.:“ohl;mor';;i”?‘::”g;:: ,.."?1",'.‘ [HOMBIBIER PioRAlTe LoD h."' daife, 70 pSss LA H9CHRITSRUTREREVAEhS oA 0y with troops and receiving commutation of quarters or of subsist- |death. In case of a father or mother hoing time of dischargs, 10 a dependent fs [F€CEIVe the most benefit from camp |at Momauguin. .1::"-":{""‘ on the veteran a statement of making application and does not ve- |a girl should attend two or more | ? i |dependency, under aat ed a8 pro- per the last rank zanizatio i b ARChE {En iy Buvkarth. andi K To— The term ‘“‘mother” and “father” {nefude in the space provided. reservations may be made for one and Ernest Griswold spent yesterday A siepmothers ‘and_stepfathers, mothers and | Ttem 13.—-This ltem ix to CoMyis. | Week. at Nooiioh, Conn & oA E B R R P 1;"'e”:|,yl:|’°”‘“ Ifi'lnml’nu, and ‘persons whe | KIONED & 1CE ONLY, If you do not re- Visitors are especialy welcome Sat- o EXAMINED' In place of a mather or fatiier |niomber exact dates give them approxi- |yrday and Sunday afternoons and as| Mr. and Mrs. William J. Sullivan . 5 ranted a farm or industrial furlough from . of the veteran at least one 3 o o v you had commisisoned serv- : Lol bl L o e e i e e eoed S | camip 15 only 14 miles from New Bri- and daughter Trene and Miss Bernar- veteran hegan his service, lice write the word “None” on the first line, : T : In case of a mentally Incapncitated de- [ jpem 16.—1n this ftem give the station |tain, it is expected many parents will [dine Cronin of 55 Linwood street viere FRANK 1 GUUDWIN the guests of Mrs, Michac) J. MeCran o . at the Mary-Don cottage at Momau- AN S S guin over the holiday. Eyesight Specialist 327 MAIN STREET Phone 1905 B0 s s ks it 0 N e p NS A G 880 b Sas She Bes ahhe g ver o |pendent the rocedura e | s 16. I (was not) a conscientious objcctor Who performed no military or naval [for a mentair capaciiared verman g 1o} (24, BhiCh Yo wera sorving when on a com- |visit the place. A special ficld day | duties whatever, and did (did not) refuse to wear the prescribed (€2l appointed guardian of the dependent |1F von Sere mover on sorn M ‘e | With water sports and contests will be | unitorm of the branch of service in which 1 was serving. |making the application: signing for the de- | “Noue” an e firsi Ine provided for sta- | held the third week of camp. Applica- 17. I was (was not) discharged for alienage. Rl | e "v‘"'yrm;‘awm n At which von served. Notice that the |tions are ‘steadily’ coming .In. A few - ent, and an affidavit setting forth the fact |sea s:vice, first two weeks. Applications may be 1y of Francis street left yesterday for et e, ohe I8 Jdentical with the person | Item 13116 this ttem applies 1o sou. sou [mafled direct to New Britain Girl {New Hampshire whero they will (ladil court order, [8hould give the date vou started to comply | g ‘. tin . lepe wek-¢ f AR An application by a dependent must be |®ith the order granting you the furlough | S¢Out Camp, Portland, Conn. epend the week-end with relati mal'ln before January 1, 1928, in erder tn he |2nd the data an which you reparted hack y . [valid, except when the veteran die to military contral. If ‘you were ordered 19. T eertify that I fln"q'p’;‘én;mwmm A ”:":f’““ in this application; [June 50, 1321 Without naving appiied fn | back from farm or indusirial furiough and . See 8 i Whicl rase the dependent may supmit an | Gid Not report far duty for four or five days C l M t Ch l that the statements made herein are made by me of my own free act [arplication any time up to six 'mnmh:a_n":.‘» atter receint of the order you must give the a eets arie and deed for the purpose of applying for Adjusted Compensation un- ('1%, veteran's death. PN SR L RS AT der the provisions of the World War Adjusted Compensation Act; [ ., s Jthervwise specified, instructions & DR Sk LY overing each item apply equally ns wa) |W111e O farm or industrial furlough and and that the same are true and correct to the best of my knowledge [tn a dependent » : & never reported for military duty give r nt submitting an application & and belief. 8 to a veteran who is peraonally appiving |\ ant? rou, etopped working, And_likewise instrictions relative to & logal | ot ampics e o afac o o X d uardian of o1l " iy h 1 L8 v o Signature Funrdian of the gieran apply to the legal | cnacientionn abjectors who peiformed no B i e Ot APPUBANE 4 civui s e s v v enan The dependent making appli military or naval duty whatever, The fact Item 20 will not Le filled in when dependent makes application, give a8 much of the required R ss thit ¥ou whrs & conad n’:.'-;,, nw“m{ ;Ilvm.- 20. ' We, the undersigned, certify that we know the person signing the ap- (et v“:r service of the veteran as{you performed unqualified military or naval plication to be identical with the veteran whose service is set forth |7*% % uu;“,"m,;“""."'” complete ftem | duty and did not refuse to wear the uni- in the above application; that we have Known him (her) for...... [ihs voteran raneerment 0 OT46F to identity LIS . D vears and ...... years, respectively; and that he (she) understands [ Be sure to fill in the space which shows }Inl apply in vour case. The ggyerning face | the statements made Ly him (her) and the penalty provided by law |XIether sour service was In the Army, [tor in this item is-whether or ot you were tor making false statements |Navy, Coast Guard, or Marine Corps, | Qischarged hecause of alienage. Although | 1tem 1.—~Give your Iast name first. then |You may have reveived ororable dis- Signature of witnesses: (1) . o ur last name first, then [You M v 1 an hororable dis (Firet) (Middle) eveeeieeniuans |your first name, followed by your migdm |ChAtRR Sl You ate mot entitied to Adjuste (Last) |name if you have one. Be sure to give the | ¢ Compensation for the Iaw specifies, “Any !!-’ml under which you served, although the | Allen—discharged from the military or A L ... [Terords may show that name different from |'AVAl forces on account of allenage,” is not Dependents must he sure (o submit with their application the affidavits |74 10 hame | For instance, your name | (1111100 (0 the benefits: accruing under this & shown in the instructions which are reqnired by law and regulations. [under the name of Grasn, of ikewies Srrven | 11em 15-This sace is protided for any The following items will be completed only when dependent makes ap- [and Smith. If vou have yvour dise hmmb‘un.lm,.\m] ; mm’u; ‘_\4»u lln.’u desire to » figs certificate or certificata in lieu with soy |[/AKe and for which thers is no space une plication for compensation 0 the name ' given thereon. Enter sa | 2Cf,An¥ o0 the itecws of the application, . K Ttem 19-—in the Apaca after the word 21. At the time #f his (her) death the veteran named in this application |eors) mumme Elven th o . r _mervics number it 20U | thet i the firat line of this {tem, fnsert had the following named dependent relatives now living: |sorved tn the Navy P 8 P & | tor the Yy, A0 the space provided | \hjel avery one of the following applies in [mevar Creraitg f you do not remember it of | your cuse, “Persan” if the yeteran {8 subs 1. Widow or widower ... . I$he _‘mrm ‘,‘;:-m":; 'dlm\' a an! through |mitting the apnlication himself; *“legal o | Sumpes 15 or the number. This |cuardian of the person (or dependent)” if Chtid , .. . vees e fumber 18 vour Army, Kavy or Marine vetersn himenif or the dependent mak- i erial of service number, Do not put [ing application ts mentally incapacitated; Date of bBIrth «..vvuu. 5 : jany. an's v|.-.,Mu Claim Number or [ “widaw." “widower,” *“child,” “mother,” or n' hing like that in this space. father” as the w83 may he, It a dependent Child AR ARG R R A o 08 i In case of a dependent making |is making application. This statement must i g ioplieation, the address of the dependent | v signed by the person making application, Wil he glven. Be sure to give your house |No one can sign for the veteran of the de- Date of birth ...... T L T R R {rumber and name of stroet, if same exist, [1ondent except in cass of mental incapacity 17 your mail s delivered In care of some |¥en the legal wuardlan of the veteran of N h one, do not fall to include thelr name as|ttpendent as the case my be will sign, Mother s . o cees part of v oaddress. In © you have | 1N the case of a veteran or the legal guard- | hoth a<husin nd reeidential address, give | /AN thereof this signature will made in Father Vriseve . [the address ur residence, Do not give | 11C Prosence of the two witnessse réquired General Delivers™ as an address if it is at |10 S€7 N ftem 200 in case of a vlnppnrh‘“ll A1l possible to give anvthing mors dofinite. legal guardian thercof the signature w 1am o ot the voteran named in this ap- (Do not ot the ronnty from tone ;:.:5::.”.4 be made at the time of the oath being (1telationship of dependent) Item 3.—This item cailn for the date of |Kieeh S84 W the prescnce o the :n.qm.n.l,‘u plication; 1 was a dependent on him (her) at the time of his (her) ’“L"” of r'*_-v‘ \ateran, ‘Z‘wg'\yzflmn of who fa [ sHI n'”\’g” 4 "“r' Yowat ::'"}"‘:"":;‘ ™ s making appli-atioy e sure to give the | o e death, at which time I was...... years old, and in uccordance with | JEXE ARniCation e wire 1o gty e lseteran and is phesicalls incapacitated, he the statement made by me in this application, 1 herehy apply for knawn o B SR 2 o &he -m‘ Agn by ma;hxyg “His :Ilpr) herefits to which T may be entitled under -he provisions of the | Item 4.—Fe sure to give rank or zrade at| Nty 1n Uje DIe0tnce of (e witnesses re- World War Adjusted Comipensation Act |ontrance into the service. It you enteied a8 | yifcant in ftem 20 \f the Applicant 18 & de- - - y s Lt 4 : N [ntre under this Item wouiq pristiened, the |ycndent and physically incapariiated, he or This is the first picture to be secured of President Coolidge with his running mate, . Charles o sl e be ‘private’ In ane will sign by making “His (Her) Mark™ : ; 5 4 ; i . i i i My address 18 ..oooiiiiiiiinns seereeesseeseesneons the word “Atmy Kay! ‘Coast Guard’ of ir tha presence of the individual *h ad- | Dawes. It was taken in Washington where Dawes and Coolidge have been discussing republican Marine Cory Fross out the three in which neinisters the oath in ftem 26, Do not emit i matters. Bignature of depcndent .».. |¥0u Q14 mot enter the seriice. Give thethe @ate under this item, space for which campaign S .