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Subj: From Norma Coffman (Pension File)
Date: 05/08/2004 11:17:49 AM Eastern Daylight Time
From: NormaCoffman@msn.com (Norma J. Coffman)
Transcription of Adjutant General’s Office Document
Adjutant General Office,
March 13th, 1863
I have the honor to acknowledge the receipt from your office of application for pension number 79694, and to return it herewithin, with such information as is furnished by the files of this office.
It appears from the rolls on file in this office, that William T. VanOrder was enrolled on the 19th day of December, 1863, at Nichols, N.Y. in 109th regiment of New York Volunteers, to serve three years, or during the war, and mustered into service as a private on the 19th day of December 1863, at Oswego, N.Y., in 109th regiment of New York Volunteers, to serve three years or during the war. On the muster roll of Co. ”K” of that regiment, for the months of May and June 1864, he is reported, “killed in action June 17th, 1864 before Petersburgh, Va.”
I am Sir very respectfully,
Your obedient servant,
Assistant Adjutant General
The Commissioner of Pensions, Washington, D.C.
Name of Applicant--------------
Proof Of Marriage.
State of New York
County of Tioga
On the 16th day of January A.D. 1865, before the undersigned, A-------------
within and for the county aforesaid, personally appeared Richard Van Valkenberg
aged 42 years, a resident of Owego, NY who being duly sworn, deposes and
says, that he is a minister of the Gospel, residing at Rome Bradford Co.
Pa that as such minister, he did unite in marriage Thomas W. VanOrder and
Rhoda J. Bush at Sheshequin, Pa., on the 17th day of September 1850, that
there is no public record of said marriage, as deponent verily believes;
that deponent is neither made, nor authorized to be made, any public church
record of said marriage; that it was not customary among the people of
said County, at the time of said marriage , to record marriages in Town
or County or State, as deponent is informed and believes; and the deponent
derives the fact of said marriage from a written memorandum made by himself
at the time of said marriage (rest unreadable) and he swears he has
no interest in the prosecution of this claim.
Richard Van Valkenberg
Subscribed and sworn to before me the day and year first above written, and I hereby certify, that the said Richard Van Valkenberg is a minister of the gospel and that I have no interest, direct or indirect, in the prosecution of this claim.
Harry Jewett, Justice Peace
State of New York
Tioga County Clerk Office.
I, Horace A. Brooks, clerk of said County, and of the County Court thereof, and one of the clerks of the Supreme Court of said State, Courts of record, do hereby certify that, Harry Jewett Esq., whose name is subscribed to the Juret of the of the annexed affidavit was, at the date of said Juret, a Justice of the Peace in and for said County, duly commissioned and sworn, and authorized by the laws of said State to administer oaths and take and certify affidavits; that I am well acquainted with his hand writing, and verily believe that his signature to said Juret is his genuine signature; and that said affidavit and Juret are in due form, and in accordance with the said laws of said State. In testimony-----hereunto subscribed my name, and affixed the seal of said Courts and County, at Owego, this 16th day of January, 1865.
H.A. Brooks, Clerk.
War of 1861
Act of July 25th, 1866
Claim for Increase of Widow’s Pension.
Supplement to case in which Certificate No. 43505 was issued March 22nd 1865.
Brief in the case of Jane VanOrder, widow of Thomas W. VanOrder, Private Co. “K” 109th N.Y. Vols.
Resident of Smithborough, Tioga County, and State of N.Y.
Post office address: Smithborough, Tioga Co. N.Y.
Declaration and Identification in due form, proof exhibited.
Abandonment or Adoption-Neither as she avers.
Date of marriage of parents- Sept. 17th 1850 or 1860
Names and dates of birth of children:
Alice –July 1st, 1861 who will be 16 years old on June 30, 1877.
Hattie- Feb. 18th, 1863, who will be 16 years old on Feb. 17, 1879.
Cora- July 9th 1864, who will be 16 on July 8th 1880.
Proof of ages. Affdt. of attending physician and others present at birth.
Only Children; Satisfactory
Agent and his P.O. Box- John S. Hopkins, Waverly, N.Y.
Issue certificate for eight dollars per month, commencing June 17th, 1864 and two dollars per month additional for each of the above-named children, commencing 25th day of July 1866, deducting former payments.
Passed June 25, 1867
War of 1861
Brief of the case of Mrs. Jane VanOrder, widow of Thomas W. VanOrder,
Private in Co. “K”, 109, N.Y. Vols.
Bradford County and State of Penn.
Act of July 14th, 1862.
Post Office address of applicant, Rome, Bradford Co, Pa., claim for widow’s pension.
Declaration and identification in due form, proof exhibited.
Service- the rolls of the Adjutant General show muster Dec. 19, 1863 and that the soldier was killed in action June 17th, 1864.
Marriage- shown by an affidavit of the officiating clergyman.
Widowhood- Identity shown by credible persons.
Children- Names and ages -------
Admitted Mar. 18, 1863 to a pension of $8.00 per month, commencing June 17th, 1864.
Charles R. Barstow Esq.
Oswego, NY W.S. Graff
State of New York
On this 4th day of October, A.D. 1866 personally appeared before the county clerk and clerk of the courts of record in and for the Tioga County Jane Vanorder a resident of Smithboro Tioga County, State of New York, aged 28 years, who being first sworn according to law doth on her oath make the following declaration in order to obtain the benefit of the provision made by the second section of the act of Congress increasing the pension of widows and orphans approved July 23rd, 1866. That she is the widow of Thomas W. VanOrder who was a Private in Co. “k” commanded by Capt. Warrick in the 109th, Regiment of the N.Y. Vol., in the War of 1861 and that by season of his death in the service aforesaid she has been granted a pension of eight dollars a month in accordance with a certificate numbered 43.303 bearing date March 22nd, 1865.
She further swears that she has the following named children of her
deceased husband and herself under sixteen years of age who are now living,
the dates of whose births were, as given below to with
Alice VanOrder Born July 1st, 1861
Hattie VanOrder Born February 18th, 1863
Cora VanOrder Born July 9th. 1864
She further declares that she has not remarried since the death of her said husband, nor has she abandoned the support of anyone of the children above named nor permitted anyone of the same to be adopted by any other person or persons as his or their child.
Post Office address is Waverly, Tioga County, New York and she hereby constitutes and appoint John S. Hopkins her true and lawful attorney with full power of substitution to prosecute this her claim to apply for and receive the increased pension to which she is entitled under the act above stated.
Jane VanOrder also personally appeared Sarah Bush and Andrew L. Bush,
residents of the County of Tioga, persons whom I certify to be respectable
and entitled to be credible and who being by me duly sworn say that they
were present and saw Jane VanOrder sign her name to the foregoing declaration
and they further swear that they have every to believe from the appearance
of the applicant and their acquaintance with her that she is the identical
person she represents herself to be, and that they have no interest in
the prosecution of this claim.
Andrew L. Bush
Sworn bounds subscribed before me this 4th day of October 1866; and I hereby certify that I have no interest direct or indirect in the prosecution of this claim
H.A. Brooks County Clerk
State of New York
Dr. George Cady being sworn deposes and says that is residing and practicing
physician of the town of Nichols in said County. That he is well acquainted
with Jane VanOrder when application for an increased pension is hereto
annexed. That he attended said Jane VanOrder during the childbirth of Hattie
VanOrder who was born February 18th, 1863.And deponent further states that
he has no interest in the prosecution of this claim direct or indirect
and further says not.
Geo. M. Cady
Sworn and subscribed before me this 16th day of October 1866, and I
hereby certify that George M. Cady is a physician and surgeon and that
he is a good and credible witness and worthy of belief, and that I have
no interest in the prosecution of this claim.
Oliver A. Barstow.
Attached to above document
State of New York
Tioga County Clerk Office
I, Horace A. Brooks, clerk of said County, and of the County Court thereof, and one of the clerks of the Supreme Court of said State, Courts of record, do hereby certify that O.A. Barstow Esq. Whose name id subscribed to the Jurat of the annexed affidavit, was at the date of said Jurat, a Justice of the Peace in and for said County, duly commissioned and sworn, and authorized by the laws of said State to administer oaths and take and certify affidavits; that I am well acquainted with his hand writing, and verily believe that his signature to said Jurat is his genuine signature; and that said affidavit and Jurat are in due form, and in accordance with the said laws of said State.
In testimony whereof I have hereunto subscribed my name, and affixed
the seal of said Courts and County, at Owego, this 24th day of Oct. 1866.
H.A. Brooks, Clerk.
State of Pennsylvania
Roxanne Richards and Sally Eastman each being duly and severally sworn depose and say each for herself that she is well acquainted with Mrs. Jane VanOrder widow of Thomas W. VanOrder who was a Private in Co. ‘K’ 109th Regiment N.Y. Vol., that she was present and attended upon said Jane VanOrder at the time of her childbirth of Cora VanOrder who was born at home in the County of Bradford and State of Pennsylvania on the 9th day of July 1864.
And deponents further state that they have no interest direct or indirect in the prosecution of this claim and are residents of Bradford County of Pennsylvania.
Sworn and subscribed before me this 29th day of November AD 1866 and I hereby certify that Roxanna Richards and Sally Eastman are good and credible witnesses and worthy of belief and that I have no interest in the prosecution of this claim direct or indirect/
Orson Rickey J.P.
Attached to above document
Commonwealth of Pennsylvania.
Bradford County, SS.
I, W. A. Thomas Prothonotary
of the Court of Common Pleas of the County and State aforesaid, do hereby certify that Orson Rickey Esquire, before whom the foregoing affidavit was made, was, at the time of so doing, an acting Justice of the Peace in and for said County, duly commissioned and sworn; that his signature thereto is genuine, and that I have no interest in this claim or application.
In testimony whereof, I have hereunto set my hand, and affixed the seal
of the said Court, at Towanda, the 7th, day of December A.D. 1866. William
A Thomas… Prothonotary.
Department of the Interior
Claim of Widow having minor Children
I certify that Jane VanOrder, widow of Thomas W. VanOrder, who was a Private Co. K 109th Regt; NY. Vols; in the service of the Service of the United States, is entitled under the provisions of an amendment to the act of July 14th, 1862, to receive pay at the rate of eight dollars per month, to commence on the seventeenth day of June, 1864, and to continue during life, unless she shall again marry, in which case the pension to her and for the within named children is not payable after the date of such marriage.
Also, there shall be paid to the widow on account of the following names
children, to commence 17th, June 1864.
Alice…who will be sixteen years of age…30th June 1877
Hattie.. who will be sixteen years of age… 17th Feb. 1879
Cora… who will be sixteen years of age.. 8th July 1880
The additional sum of two dollars per month for each child until arriving
at the age of sixteen years; provided such child has not before that date,
married, died, or been adopted or abandoned, first payment to be deducted.
Given at the Department of the Interior, this fifth day of July, one thousand eight hundred and sixty seven.
W.T. Otto, Acting Secretary of the Interior.
Commissioner of Pensions
Attached to the previous Document in the year of 1909.
Note- This circular is to be securely attached to the Pension Certificate.
Certificate NO. 43505
Department of the Interior --- Pension Office – Washington, D.C
Name of Pensioner: Jane VanOrder—May 1st, 1886
An act to increase the pension by the Senate and the House of Representatives of the United States of America in Congress assembled, that from and after the passage of this act the rate of Pension for widows, minor children and dependant relatives now on the pension roll, or hereafter to be placed on pension roll, and entitled to receive a less than hereinafter provided, shall be twelve dollars per month; and nothing herein shall be construed to affect the existing allowance of two dollars per month for each child under the age of sixteen years; provided that this act shall apply only to widows who were married to the deceased soldier or sailor prior to its passage and to those who may hereafter marry prior to or during the service of the soldier or sailor, and all acts or parts of acts inconsistent with the provisions of this act are hereby repealed.
That no claim agent or attorney shall be recognized in the adjudication of claims under this act, nor shall any such person be entitled to receive any compensation whatever for services or pretended services in making applications thereunder. Approved March 19th, 1886.
Acting Secretary of the Interior
John C. Black
Commissioner of Pensions
State of New York
Pension Certificate No. 43505
On this 5th day of August, 1870 before me the subscriber a Justice of
the Peace for said County of Chemung personally appeared Jane VanOrder
who on her oath declares that she is the widow of Thomas W. VanOrder, deceased
who was a Private in Company “K” 109th Regiment, New York State Volunteers
in the service of the United States and that he formerly belonged to Capt
Warricks Company Col. Tracy’s Regiment; that her name was placed on the
pension roll of the Pennsylvania Agency Philadelphia; whence she
has [ unreadable]
Chemung County State of New York where she intends to remain and wishes her pension to be payable at Canadaigua, N.Y. in future. The following are her reasons for moving from Pennsylvania to New York. Her parents and other relatives reside in Chemung County, N.Y.
Sworn and subscribed to before me the day and year aforesaid
Moses Cole Justice of the Peace Jane VanOrder, Millport, N.Y.
In and for Chemung County.
State of New York, Chemung County
Mary Tompkins and Mordecai Williams
of Millport, N.Y.
In said County being each duly sworn and says that they are acquainted with the above named Jane VanOrder widow of Thomas W. VanOrder deceased and that an original certificate no.43505 for pension to said Jane VanOrder and her three minor children is now in her possession and has been examined by us and we know her to be the pensioner therein named.
Scribed and Sworn to this 5th day of August 1870 before me
Moses Cole Justice of the Peace in and for Mordecai Williams
Attached to above Document
State of New York
Chemung County Clerks office
I, Robert F. Stewart, clerk of said County, and also Clerk of the Court in and for said County, (Courts of Record), do hereby certify, that Moses Cole who’s name is subscribed to the foregoing affidavit and thereon written, was at the time of the taking of the same, a Justice of the Peace in and for said County, swelling in said County, commissioned and sworn, and duly authorized to take the same, and further, that I am well acquainted with his hand-writing and verily believe that the signature if said Cole to the said affidavit, is genuine. In witness whereof, I have hereunto subscribed my name and affixed the seal of courts and county, at Elmira, this 6th day of Aug. 1870.
State of Illinois
Mrs. Absalom Serene and Roxanna Jones each being duly and severely sworn deposes and says each for herself, that she is well acquainted with Mrs. Jane VanOrder, widow of Thomas W. VanOrder, who was a Private, Co. “K” 109th regiment N.Y. Vol. That she the said deponent attended upon the said Jane VanOrder at the time of the childbirth of Alice VanOrder, who was born July 1st, 1861 at Northville in the county of LaSalle, State of Illinois. That said deponent remembers the time and place of said childbirth from a distinct recollection of the time and place and of their presence at the time of the childbirth. And deponent further states that they have no interest in the prosecution of this either direct or indirect and further say not.
Sworn and subscribed before me this 27th day of October 1866, and I
hereby certify that Mrs. Helen Serene and Roxanna Jones are good and respectable
witnesses and worthy of (unreadable) and that I have no interest in the
prosecution of this claim.
Attached to copy of above document
State of Illinois
I, Absalom B. Moore, clerk of the county court in and for said county and state aforesaid, do hereby certify that William Sly, Esquire, before whom the annexed instrument in writing was proved or acknowledged, was at the time of taking the same, and acting Justice of the Peace in and for said county, duly commissioned and qualified; and that I am well acquainted with the handwriting of such justice, and verily believe his signature to said certificate is genuine; and that said instrument is executed and acknowledged in accordance with the laws of this state.
In testimony whereof, I have hereunto set my hand and affixed the seal of said court, at Ottawa, this 19th day of November 1886.
Application for Reimbursement
(This application, when properly executed before some officer having authority to administer oaths for general purposes, should be forwarded, together with the pension certificate and itemized bills of all expenses, to the commissioner of pensions, Washington, D.C.)
State of New York
County of Chemung
On this 14th day of September, A.D. one thousand nine hundred and nine personally appeared before me, a Notary Public within and for the county and state aforesaid, Sarah E. Dailey, aged 38 years, a resident of Millport, county of Chemung, state of New York, who being duly sworn according to law, makes the following declaration in order to obtain reimbursement from the accurred pension for expenses paid (or obligation incurred) by claimant for the last sickness and for the burial of Jane VanOrder, who was a pensioner of the United States by certificate No. 43505. Pension was last paid to April 4th, 1909, by the U.S. pension agent at Buffalo, N.Y.
That my post office address is No.----, on----Street, in the town or
city of Millport, County of Chemung, State of New York.
That the answers to questions propounded below are full, complete, and truthful to my best knowledge, information, and belief, and that no evidence necessary to a proper adjustment of all claims against the pension accured is suppressed or withheld.
1. What was the full name of the deceased pensioner? Jane VanOrder.
2. 2. In what capacity was decedent pensioner? (as invalid soldier, or sailor, or as a widow, minor child, dependent relative, etc.) Widow
3. If decendent was pensioned as an invalid soldier or sailor—
A. Was he married? (Answer yes or no)
B. How many times, and to whom?
C. If married, did his wife survive him? (answer yes or no)
D. If so, is she still living?(answer yes or no)
E. If not living, give full names and dates of death of all wives.
F. Was he ever divorced? (answer yes or no)
G. If so, did the divorced wife survive him? (answer yes or no)
H. If so, is she still living? (answer yes or no) (if living, a copy of the decree of divorce must be filed)
I. If not living, give her full name and the date of her death.
4. Did pensioner leave a child under 16 years of age? (answer yes or
5. Is any such child still living? (answer yes or no) no
6. Was the pensioner’s life insured at the time of death? (answer yes or no) yes
7. If so, give the name of each company in which a policy was carried and the amount in which each policy was written: I think $40.00 Metropolitan Life Insurance N.Y. City.
8. Who was the beneficiary named in each policy? It was a burial insurance made to her.
9. What was the relation of each beneficiary to the pensioner?
10. Were the premiums paid by the deceased? Yes
11. If not paid by the deceased pensioner, state the amount of premiums paid by each person who made payment on that account:
12. Did the pensioner leave a will? (answer yes or no) No
13. Was an administrator appointed, or will application be made for appointment of any person as administrator? No
14. Did the deceased pensioner leave any money, real estate, or personal property? No
15. If so, what was the character and full value of all such property? Nothing
16. What was the assessed value (last assessment) of the real estate? Nothing
17. How was the pensioner’s property disposed of? She had none.
18. Did the pensioner leave an unendorsed pension check? (answer yes or no) no
19. What was your relation to the deceased pensioner? Sister
20. Are you married? (Answer yes or no) I am a widow.
21. When did the pensioner’s last sickness begin? May 4th, 1909
22. Give the name and post-office address of each physician who attended the pensioner during last sickness: George M. Beard M.D., Horseheads, N.Y.
23. What was the nature of the pensioner’s last sickness? Umbilical hernia, causing hemorrhages of bowels.
24. State the names of the persons by whom the pensioner was boarded during the period or any portion of the last sickness and the period for which the board was furnished: Sarah E. Dailey, 1st Sept. 1908 to May 28th 1909.
25. State the names of the persons by whom the pensioner was nursed during the period or any portion of the period of sickness and the period covered by such service in each instance: Sarah E. Dailey who gave her constant care 9 months Sep. 1st 1908 to May 28th 1909.
26. Where did the pensioner live during last sickness? With Sarah E. Dailey, Millport, N.Y.
27. Did the pensioner pay rent? No
28. Where did the pensioner die? Millport, N.Y.
29. When did the pensioner die? May 28th, 1909
30. Where was the pensioner buried? Pine Valley, N.Y.
31. Has there been paid, or will application be made for payment to you or to any other person, any part of the expenses of the deceased pensioner’s last sickness or burial by any state, county, or municipal corporation? (Answer yes or no ) yes
32. If so, what is the amount of such payment, and to whom has it been or will it be made? (Furnish a copy of the itemized bill or receipt for each such payment.) 35 dollars pay to Hibbard Undertaker by the County of Chemung, N.Y. He has not received amount yet. I only have to pay it.
33. State below what expenses were paid or incurred by you during the pensioner’s last sickness and for burial. Write the word none where no charge is made in case of any item of expense noted. (each charge enumerated below should be supported by an itemized bill of the person who rendered the service or furnished any supplies for which reimbursement is demanded, and should show, over his signature, by whom paid, or who is held responsible for payment, and contain the name of the pensioner for whom the expense was incurred or service rendered.)
Name Whether pd or unpaid Nature of expenses State amount
George M. Beard Paid Physicians bill 4.00
George M. Beard Medicine None
Sarah E. Dailey Board none
Sarah E. Dailey Unpaid Nursing care 100.00
Sterling Bros. Unpaid Groc. & other living expenses for use of pensioner 16.20
E. Hibbard Paid Undertaker’s bill 60.00
H.D. Burris Paid Cemetery charges 4.00
E. Warring Unpaid Coal 15.72
34. Is the above a complete list of all expenses of the last sickness
and burial of the deceased pensioner? (Answer yes or no) Yes
(When the claim for reimbursement is a married woman she is required to sign the application with her own full name, no using the Christian name or the initials of her husband, and all bills should be receipted to her in her name.)
Attest: 1. Jerome Kendell
2. Elizabeth W. Hankins
Sarah E. Dailey (Claimant’s signature in Full)
Also personally appeared Jerome Kendall and Elizabeth W. Hankins, person whom I certify to be respectable and entitled to credit, and who, being duly sworn, say that they were present and saw Sarah E. Dailey, the claimant, sign her name (or make mark) to the foregoing declaration; that they were acquainted with Jane VanOrder, the pensioner named in the foregoing application, and that they know the claimant herein; that they have read all the questions, answers, and declarations in said application and believe the facts therein set forth to be true; and that they have no interest, direct or indirect, in this claim.
Elizabeth W. Hankins
Subscribed and sworn before me this 14th day of September, A.D. 1909; and I hereby certify that the contents of the above declaration, etc., were fully made known and explained to the applicant and witnesses before swearing, including the words----added; and that I have no interest, direct or indirect, in the prosecution of this claim.
Eula M. Briggs
Statement of Attending Physicians.
1. Give date of commencement of the pensioner’s last sickness.- May
2. Give date of pensioner’s death.-May 28th, 1909.
3. During what period did you attend the pensioner? 4 days
4. State nature of disease from which the pensioner died. -Hemorrhage of bowels, result of very large umbilical hernia.
5. State whether there was necessity for nursing or other attendance.- Required constant attendance.
6. Give length of time for which such services were necessary.- About nine months.
7. Give name of each person who rendered service as nurse, and who has made or make a charge for such service. – Mrs. Sarah E. Dailey.
8. Give name of any other physician who attended the pensioner during his last sickness.- None
9. Does your bill include a charge for all medicines furnished the pensioner during the last sickness? Yes
10. State whether you have read the questions in the foregoing application, and the claimant’s answers thereto, and whether such answers are correct according to your best knowledge, information, and belief.- I have. They are.
11. Mention any other facts within your knowledge which, in your opinion, would be helpful in adjusting this claim for reimbursement.- Her hernia was so large that the greater protrusion of the bowels escaped from abdominal cavity rendering her helpless during the last nine months of her life.
I certify that the foregoing statement is correct.
September 7, 1909
George M. Beard M.D.
Transcription of return of Undertaker bill
Please read this and I have drawn up a bill that will meet the requirements of this, you may sign it or write one similar to it. I stand responsible for the burial and no one else. I put in this claim to cover the whole amount. Please put the bill in addressed envelope and put it in the office at (unreadable). Please give it your immediate attention and I will make it right- Do not send this.
Sarah E. Dailey