from The Webster Times, July 18, 1863 (Volume V # 19), 

OFFICE OF PROVOST MARSHAL,
8TH DISTRICT MASSACHUSETTS
, Worcester ,

July 10, 1863
Headquarters, No. 245 Main Street
Worcester Mass.

In accordance with directions received from the War Department, the Board of Enrollment for this district, hereby publish “for the information of the public” the following forms of affidavits and certificates under the “Act for enrolling and calling out the national forces, and for other purposes,” approved March 3, 1863.     
Form 25

Certificates of exemption for the son of a widow, or of aged and infirm parent or parents.

I, the subscriber,  ------------------  resident of  ----------,  ------------------- county, state of Massachusetts, hereby certify that I  -------------------- being liable to military duty, under the act of congress for “enrolling and calling out the national forces, & ect.,” approved March 3, 1863, am the only son of ---------- ----------------,  a widow, (or of  ---------- ---------------- , an aged parent,) dependent on my labor for support.
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Personally appeared before me ----------- ------------------, the above named ---------- and ----------, and severally made oath that the above certificate is correct and true to the best of their knowledge and belief.    
 
----------, Justice of the Peace
Dated this ----- day of -----, 1863.

Note1. The first of the above certificates must be signed by the person claiming exemption , and the second of two respectable  citizens (heads of families) resident in the town, county or district in which the person resides, and sworn to before a magistrate

Note 2 this certificate is to be used only in cases where the labor of the person claiming exemption is actually necessary for the support of the persons dependent on him.  The exemption does not apply in cases where there is sufficient property to yield support, and the necessary business for collecting the income can be transacted by agents, trustees, or the like.


Form 26

Certificate of a parent that he or she desires one of his or her sons exempted.

I, the subscriber, the father (or mother) of  ----------  and  ----------,  resident of  ----------, ----------  county, state of Massachusetts, hereby certify that I am aged and infirm, and that I am dependent for support on the labor of my two sons, above named, and that I elect that my  ---------- son, ----------,  shall be exempt from the operations of the act of  congress for enrolling and calling out the national force, &c., approved March 3, 1863

We the subscribers, do hereby certify that the above named ----------  is aged and infirm, and dependant on the labor of --------- sons for support.

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Personally appeared before me the above named ---------- and ----------, and severally made oath that the above certificates are correct and true, to the best of their knowledge and belief.

 ---------- , Justice of the Peace
Dated at ---------- this ----------- day of ----- 1863.

Note 1. The first certificate must be signed by the parent making the election, and the second by two respectable citizens(heads of families) residents of the town, county or district in which the persons reside, and sworn to before a magistrate.  In case the father is deceased, the certificate is to be signed by the mother, and the fact of the fathers death is to be stated by the persons certifying.

Note 2.  This certificate is to be used only in cases where the labor of the person claiming exemption is actually necessary for the support of the persons dependent on him.  The exemption does not apply in cases where there is sufficient property to yield support, and the necessary business for collecting the income can be transacted by agents, trusties, or the like.


Form 27

Certificate that the person liable to draft is the only brother of a child or children dependent on his labor for support.

I, the subscriber, ----------- ----------, being liable to draft in service of the United states, hereby make affidavit that I am the only brother of ---------- ----------, under twelve years of age, having neither father nor mother, and dependent on my labor for support.

We, the subscribers, ---------- ----------, and ---------- ----------, residents of ---------- county, state of Massachusetts hereby certify that  ---------- ----------, who is liable to draft, is the only brother of ---------- ----------, under twelve years of age, having neither father nor mother and dependent on his labor for support.  

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Personally appeared before me the above named ----------- -----------, and ---------- ----------, and severally made oath that the above certificate is correct and true, to the best of their knowledge and belief.

 ---------- , Justice of the Peace
Dated at ---------- this ----------- day of ----- 1863.

Note 1 This certificate is to be used only on cases where the labor of the person claiming exemption is actually necessary for the support of the person dependent on him.  the exemption does not apply in cases where there is sufficient property to yield support, and the necessary business can be transferred for collecting the income by agents, trustees, and the like.

Note 2 The first certificate must be signed by the person claiming exemption and the second by two respectable persons (heads of families ) resident in the same town, county, or district with the person for whom the exemption is claimed.


Form 28

Certificate that two members of the family of the person liable to draft are already in the military service of the United States .

We, the subscribers, -------------------, and ------------------ residents of ----------, ---------- county, state of ----------, hereby certify that two members of the family and household of  ------------------- ------------------- county and state above mentioned, are in the military service of the United States, as non-commissioned officers, musicians, or privates.

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Personally appeared before me the above named ---------- ----------, and ----------, and severally made oath that the above certificate is correct and true, to the best of their knowledge and belief.

 ---------- , Justice of the Peace
Dated at ---------- this ----------- day of ----- 1863.

Note 1  This is only intended to apply where the members of the family claiming exemption reside in the same family.  If any of the members reside elsewhere, and have gone into the military service of the United States , no exemption on that account can be claimed

Note 2  This certificate must be signed by one of the parents, if there be any; if not , by two respectable persons (heads of families ) resident in that town, county, or district with the person for whom exemption is claimed.


Form 29

Certificate that the person liable to draft is the father of motherless children, under twelve years of age, dependent on his labor for support.

I, the subscriber, ------------------ ------------------, being liable to draft into service of the United States, hereby make affidavit that I am the father of --------- ----------, motherless child, under twelve years of age, and dependent on my labor for support.------------------

We, the subscribers, --------- ----------, and --------- --------- residents of --------- county, state of Massachusetts , hereby certify that ---------- ---------- is father of ----------- motherless children under 12 years of age, and dependent on his labor for support.

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Personally appeared before me the above named ----------- ----------, and ---------- ----------, and severally made oath that the above certificate is correct and true, to the best of their knowledge and belief.

 ---------- , Justice of the Peace
Dated at ---------- this ----------- day of ----- 1863.

Note The first certificate must be signed by the person claiming exemption, and the second by two respectable persons (heads of families)  resident in the same town, county or district with the person for whom the exemption is claimed.


Form 30

Certificate of exemption on account of unsuitableness of age.

I, ---------- ---------, of ---------,---------- county, state of ----------, having been enrolled under the previous act of congress “for enrolling and calling out the national forces,” &c., approved March 3,1863, as liable to perform military duty in the service of the United States, hereby certify that I am not legally subject to such liability, and for the following reasons:

That I am ---------- years of age.

We the subscribers, ---------- ----------, and --------- ---------, of the town, county and state above mentioned, hereby certify that the above statement is  correct and true to the best of our knowledge and belief.  

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Personally appeared before me the above named ---------- ----------, and ---------- -----------, and severally made oath that the above certificates are correct and true to the best of their knowledge and belief.  

 ---------- , Justice of the Peace
Dated at ---------- this ----------- day of ----- 1863.

Note 1.  The certificate in regard to age is in all cases, where practicable, to be signed by the parents of the person claiming exemption, and the requirements specified in the regulations are to be adhered to.  The blank space in the certification to indicate the age of the person is to be filled as follows:
That I am “UNDER TWENTY “ years of age.
That I am “OVER THIRTY_FIVE” years of age, “AND MARRIED.”
That I am “OVER FORTY_FIVE” years of age,
according to the facts of the case.

Note2.  In case the certificate is not signed by the parents, the fact of age must be certified to by two respectable persons (heads of families) residing in the same town, county, or district with the person for whom exemption is claimed, and the requirements of paragraph 61, Regulations, &c,. must be complied with.


Blanks of these forms to be obtained by application at this office, daily, (except Sundays) between the hours of two and five P. M.

All persons who may be drafted, and who desire to present substitutes, must give notice in writing to the Board of Enrollment that on such a day they will present a substitute, giving his name, residence and age, and stating whether he is an alien or a citizen.

The Collectors of Internal Revenue have been authorized by the Secretary of War, and directed by, the Secretary of the Treasury, to receive from drafted persons, who desire to pay it, the sum of $300, in commutation of service.  ADIN THAYER, Esq., No. 218 Main street , Worcester , Mass. is Collector for the Eighth District, and will receive payment for this District.

SAM’L V. STONE. Capt. and Provost Marshal.

CHAS H. DEANE, Commissioner.

ORAMEL MARTIN, Surgeon.

 

15th Massachusetts VI