No. _111007
C-8
412
FORM NO. 3.
Required for placing on the Pension List, the Widow of an Officer who died on Half-Pay.
I Elizabeth Cameron do solemnly and sincerely declare, that I was lawfully married at Grand Manan on the twelfth day of January -- 1842 to John Cameron late a Lieut. of the Orange Rangers on Half-Pay of the Regiment of Rangers who died at Grant Manan on the 21st day of May 1844 aged eighty eight years;--that ever since his decease I have continued a Widow, and am so at this present time;--and that I have no Pension, Allowance, or Provision from Government. And I make this solemn declaration, conscientiously believing the same to be true, and by virtue of the provisions of the Act 5 and 6 William IV, Cap. 62?.
Signature of the widow} Elizabeth X (her mark) Cameron
Her Place of Residence} Grand Manan Charlott County, N.B.
Declared and Subscribed before me at this twenty seven day of August 1845
Signature of the Magistrate} Church Meigs, __
Place or County for which he Acts.} Charlotte County
N.B.--If the Marriage of the parties took place before the Officer was placed on Half-Pay, the following Certificate must be filled up and signed in the manner pointed out below; but if the Marriage took place after the Officer was placed on Half-Pay, the Certificate is not required. [Note: It was not filled out]
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