Declaration for Original Invalid Pension of Adam Floyd 33rd USCT September 4, 1879
Transcription Declaration for Original Invalid Pension. Must be executed before a Court of Record or some officer thereof having custody of its seal.
State of Florida County of St. Johns
On this 4th day of Sept, A. D. one thousand eight hundred and seventy 9 personally appeared before me a clerk of the court of the 4th Judicial Circuit ?, a court of record within and for the County and State aforesaid Adam Floyd, aged 63 years, a resident of St. Augustine County of St. Johns State of Florida who being duly sworn according to law, declares that he is the identical Adam Floyd who entered service under the name of Adam Floyd on the 5th day of Jany, 1863 as Private in company "I" of the 33 regiment of USCT commanded by Capt John M. Thompson and was honorably discharged at Fort Wagoner, S. C. on the 31st day of Jany 1866 by reason of expiration of term service that his personal description is as follows: Age, 63 years; height, 5 feet 4 1/2 inches; complexion black; hair black; eyes black. that while a member of the organization aforesaid, in the service and in the line of his duty at Morris Island in the State of S. C. on or about the ____________ day of __________ 18 __________ he incurred a rupture of the right side caused by lifting and straining while moving quarters. That he was treated in hospitals as follows: Roven Hospital, Charleston S. C. about five months. That he has not been employed in the military or naval service otherwise than as stated above. That since the 31st day of Jany A. D. 1866 he has not been employed in the military or naval service of the United States. That since leaving the service this applicant has resided in and about St. Augustine in the State of Florida and his occupation has been that of a Farmer, That prior to his entry into the service above named he was a man of good, sound, physical health, being when enrolled a Waiter. That he is now wholly or in part disabled from obtaining his subsistence by manual labor by reason of his injuries above described, received in the service of the United States; and he therefore makes this declaration for the purpose of being placed on the invalid pension roll of the United States.
He hereby appoints, with full power of substitution and revocation, George E. Lemon of Washington, D. C., his true and lawful Attorney, to prosecute his claim. That he has never received or applied for a pension. That his Post Office Address is St. Augustine county of St. Johns State of Florida
Adam his mark Floyd
Notes: 1. This is the first document needed in the process of getting a pension.
2. He paid $10 to get the services of George E. Lemon to help process the pension.
3. He would need to prove that this was a service related injury and the amount of that injury