Civil War Application Questionaire


Application  17 May 1902
What is your age?
60 years

Where were you born?
Claiborne County Tenn.

How long have you resided in Virginia?
18 Years

What is your usual and ordinary occupation for earning
livelihood ? 
Farming ____ labor.

How long have you followed such occupation or employment?
Nearly all my life.

Have you followed such occupation within the last two years?
I have not been able to work for the last two years. And my
annual income has amounted to nothing..

Are you totally disabled from following your usual occupation or
any other employment by which you can earn a livelihood?
My disability is total. I frequently loose my voice because of the
wound in my breast. I am very week because of the wound and cannot work.

When did you enter the service in Virginia or the Confederate States?
Near Cumberland Gap in April 1861

To what command and service were you first assigned. Who were your immediate
superior officers? 
Cavalry Service. Company E. Capt. Brooke White Reg.

How long were you in service? 
61-65

Give names and addresses of two more survivors of your command when you were
wounded if any such not living so state?
Caloway Hurst, Grapevine Texas; John Hurst, Postmaster, Whitesburg, Tenn.

Is there any Camp of Confederates in the city or county of residence?
Breathed Camp

Is there anyone living in residence who knows you comrade or other that
knows of your service and wound?
W. W. Southern, Newport Va. Hugh Southern, Allisonia, VA