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{DATE) SiR: request that my claim to Bounty Land, under the 9lh section of tiie act of lhe llth of February, l847, entitled ".An ac, to raise for limited time an additional military force, and for other purposes" may be ex- amined; and If am entitled to Land, wish to leIinquish, and do hereby relinquish, my right thereto, and in lieu thereof to receive a Treasury Scrip far one hundred dollars. Attest: ] am, respectfully,

 your obedient sev't. To the Commissioner of Pensions.

 Washington Gig.

 B.

 It is hereby certified, that satisfactory proof has been exhibited before ihe r. for the county of--in the State oi--- by the ailidayiis of--and-- who are persons entitled 10 credit, thal--- ---aDd------are the ouly surviving + children of--who was a-in the United States seTvlce.r

 In testimony whereof have set

 my hand and seal of office this

 -!ay of--in the year