6

Reproduced at the National Archives
3-402.
Certificate No. 932739
Name, Newton Jackson

Department of the Interior,
Bureau of Pensions
Washington, D.C. January 15, 1898

SIR:
In forwarding to the pension agent the executed voucher for your next
quarterly payment please favor me by returning this circular to him with
replies to the questions enumerated below.
Very respectfully,
H Clay Evans
Commissioner.

First. Are you married? If so, please state your wife's full name and her maiden name.
Answer: No
Second. When, where, and by whom were you married?
Answer: /
Third. What record of marriage exists?
Answer:/
Fourth. Were you previously married? If so, please state the name of your former wife and the date and place of her death or divorce.
Answer. Never was married.
Fifth. Have you any children living? If so, please state their names and the dates of their birth.
Answer. No

Newton X Jackson
his mark
Date of reply, May 5, 1898
Witnesses to mark