Hillsborough County, Florida
Confederate Home Applications


Application for Membership

To The Florida Confederate Home.



State of Florida,
Hillsborough County,

Before me a Notary Public in and for the State of Florida at Large, personally appeared W. S. West to me well known, who, being by me duly sworn, makes the following statement:

My name is W. S. West, I am 80 years years of age, I reside in Hillsborough County, State of Florida, I enlisted on the 15th day of January 1862, in Captain J. C. Richard Company, 10th Regiment and served faithfully in the Confederate Army until 1865. I never deserted said service and never served against the Confederate States and I have not taken the Oath of Allegiance to the United States before April, 1865. I am, and have been a bonifide resident of the State of Florida ever since January 1, 1893. I have no means of support and am physically disabled from making a living by reason of (Here state fully cause of disability.) Old Age and that I am not addicted to the use of intoxicants opiates or narcotics.
Wherefore I make application for admission as a beneficiary of the Confederate Home, located at Jacksonville, Florida, and I agree to observe all the rules prescribed by the authorities in charge of said Home.

Sworn to and subscribed before me this
21st day of Oct, 1915.
M. J. McMullen, Notary Public

W. D. West (his signature)



State of Florida,
Hillsborough County,

Before me, a Notary Public in and for the State of Florida at Large, personally appeared B. F. Taylorwho being duly sworn says that the is well acquainted with the above named _________________________________that he the said W. S. West served faithfully in the Confederate Army and did not desert said service. That he has no means of support, and deponent believes him to be physically disabled from making a living.

Sworn to and subscribed before me this
21st day of October, 1915.
M. J. McMullen, Notary Public

B. F. Taylor (his signature)
A. G. Baker (his signature)


PHYSICIAN'S AFFIDAVIT



State of Florida,
Hillsborough County,

Before me, a Notary Public in and for the State of Florida at Large, personally appeared D. A. Campbell, who being duly sworn says that he is a practicing physician duly authorized under the laws of Florida; that he has carefully examined W. S. West the above-named applicant for admission to the Confederate Home and finds him to be (Here particularly describe his physical condition) and that he is of sound mine and not demented, and that he is not afflicted with any repulsive or contaious disease likely to jeopordize others in consequence whereof he is physically disabled from earning a living.

Sworn to and subscribed before me this
21st day of October, 1915.
M. J. McMullen, Notary Public

D. A. Campbell, M. D. (his signature)


Entered the home, October 25, 1915, admit bearer on probation. Approved 1st Nov 1915.



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