EXCLAMATION.
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 fn order to obiaiR tise beae6t of ihe laird see-

 tio. of Lhe act of Congress cf ihe 4iA Js-

 ~, 1886.

 STATE TERRITORY, on DISTRICT

 of

 ON ,his--tlay oF----~----, personally appeared before the---of ibe-------, \. B. a resident ot---, in the county ol----aIid State, Territory, or District of-----, aged

 -yeers, who being frs, daiy sworn ac. cording io law, doth, on her oath make the following declaration, m order to obtain the benefit of the provision made by tie act of Congress. passed July 1, 1886. That she is lbe widow ef---, who was here insert the rank the husband held in the army, navy, or militia, as the case may Le, and specify the service performed, as directed in rule number four of these regulanons.l