Declaration for Pension (21 Jul 1921)

On 31 May 1921, Alfred Brunson Kephart suffered a paralytic stroke. His wife, Mary, filed the Declaration for Pension seen below.


Declaration for Pension (21 Jul 1921). Image courtesy of Verla Williams.

STATE OF Minnesota, COUNTY OF Jackson, ss:

On this 21st day of July, A. D. 1921, personally appeared before me, a Notary Public, within and for the county and State aforesaid, Mary Kephart, wife of Alfred B. Kephart, who being duly sworn according to law, declares ["said Alfred B. Kephart" added] that he is 79 years of age, and a resident of Lakefield, county of Jackson, State of Minnesota; and that he is the identical person who was ENROLLED at Cottage Hill, Iowa, under the name of Alfred B. Kephart on the 22nd day of August, 1862, as a Private in Company H - 21st Regt. Iowa Vol. Inf. in the service of the United States, in the Civil War, and was HONORABLY DISCHARGED at Baton Rouge, La., on the 15th day of July, 1865. That he also served ____.

That his personal description at enlistment was as follows: Height, ___ inches; complexion, ____ color of eyes, ____; color of hair, ____; that his occupation was ____; that he was born ____, 18__, at _____. Have no data available, and his condition is such that no information can be had from him.

That he requires the regular personal aid and attendance of another person on account of the following disabilities: Had paralytic stroke, and left paralyzed. Can move left hand a little, but can't walk, or talk, help himself in any way. Can understand but little of what is said to him. Has been in this condition since the stroke on May 31, 1921. He is confined to his bed entirely, except when we set him up in a reclinging wheelchair for short periods.

That since leaving the service he has resided at Lakefield, Jackson County, Minnesota, and his occupation has been farming until he retired when couldn't work any more.

That he has ___ applied for pension under Original No. ___. That he is ___ a pensioner under ["Reissue" added] Certificate No. 879.556. That he makes this declaration for the purpose of being placed on the pension roll of the United States under the provisions of the act of May 1, 1920.

(1) H. H. Sontag (Signature of first witness)
Lakefield, Minn.
(2) O. Thoreson (Signature of second witness)
Lakefield, Minn.

Mary Kephart (Claimant's signature in full)
Lakefield, Minnesota

SUBSCRIBED and sworn to before me this 21st day of July, A. D. 1921, and I hereby certify that the contents of the above declaration were fully made known and explained to the applicant before swearing, including the words "on opposite page" erased, and the words "on opposite page", added; and that I have no interest, direct or indirect, in the prosecution of this claim.

O. Thoreson (Signature)
Notary Public, Jackson Co., Minn.
My commission expires Jan. 15, 192 [illegible]
Lakefield, Minnesota

Declaration for Widow's Pension (13 Jan 1922)

On 21 December 1921 Alfred Brunson Kephart passed away. His wife, Mary, soon after applied for a widow's pension. It and the supporting documents can be found below:


Declaration for Widow's Pension (13 Jan 1922). Image courtesy of Verla Williams.

State of Minnesota, County of Jackson

On this 13th day of January, 1922, personally appeared Mary Kephart before me the undersigned, who makes the following declaration as an application for pension under the provisions of the act of Conress approved May 1, 1920.

That she is 72 years of age, that she was born June 3, 1849 at Dubuque County, Iowa, and that her post-office address is Lakefield, Minnesota.

That she is the widow of Alfred B. Kephart, who ENLISTED August 22, 1862, at Cottage Hill, Iowa, under the name of Alfred B. Kephart, in Co. H. 21st Regiment, Iowa Vol. Infantry, and was honorably DISCHARGED July 15, 1865, having served ninety days or more, or was discharged for, or died in service of the United States of a disability incurred in the service in the line of duty, during the CIVIL WAR, and who DIED December 21, 1921, at Lakefield, Minn.

That he also served in ____ and that, except as herein stated, said soldier (or sailor [crossed out]) was not employed in the military or naval service of the United States; THAT SHE WAS MARRIED to said soldier (or sailor [crossed out]) December 25, 1867, at Dubuque County, Iowa, by William Glew, that she had not been previously married, that he had not been previously married;

That she was not divorced from the soldier (or sailor [crossed out]) and that she has NOT remarried since his death;

That the following are the ONLY children OF THE SOLDIER (or sailor [crossed out]) who are now living and are under sixteen years of age; None

That she has not heretofore applied for pension, the number of her former claim being ____; that said soldier (or sailor [crossed out]) was a pensioner, the number of his pension certificate being 879.556.

(1) Wm Kephart (Signature of first witness)
Lakefield, Minnesota
(2) O. Thoreson (Signature of second witness)
Lakefield, Minnesota

Mary Kephart (Claimant's signature in full)
Lakefield, Minnesota

Subscribed and sworn to before me this 13th day of January, 1922, and I hereby certify that the contents of the above declaration were fully made known and explained to the applicant before swearing, including the words "or sailor" erased, and the words ____ added; and that I have no interest, direct or indirect, in the prosecution of this claim.

O. Thoreson
Notary Public, Jackson County, Minn.
My Commission expires [illegible] 15th, 1927
Lakefield, Minnesota


Certified Copy of Death Register. Alfred B. Kephart (21 Dec 1921). Image courtesy of Verla Williams.



Affidavit Re: Marriage of B. Kephart to Mary Meyers (12 May 1922). Image courtesy of Verla Williams.


B. Kephart--25 to Mary Meyers--18

On application of said Kephart and satisfactory proof license issued this 16th day of December 1867. The marriage of the above named parties was solemnized on the 26th day of December 1867, by William Glew, a Justice of the Peace.

STATE OF IOWA, Dubuque County, ss:

I, M. J. Grace, Clerk of the District Court in and for said county do hereby certify that the foregoing is a full, true and compared copy and transcript of the record of marriage of B. Kephart and Mary Meyers, as the same appears of record and on file in my office.

IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal of said courty at my office in the city of Dubuque this 12th day of May 1922.

M. J. Grace Clerk District Court
By Geo. Wieger Deputy


Affidavit of James Rost (23 May 1922). Image courtesy of Verla Williams.

STATE OF MINNESOTA, COUNTY OF JACKSON, ss.

James Rost being first duly sworn, deposes and say that he now is and for more than thirty years last past has been a resident of Lakefield, in the County of Jackson, State of Minnesota; that during all of said time he has been personally well acquainted with Alfred B. Kephart and Mary Kephart, his wife; that he knows that during all of said time and until the death of the said Alfred B. Kephart, the said Alfred B. Kephart and Mary Kephart were continuously living together as husband and wife in the Village of Lakefield ^ and in the vicinity of Lakefield, in said County and State, and that they continued so to live as husband and wife until the death of the said Alfred B. Kephart; that they were never divorced.

James Rost

Subscribed to before me this 23rd day of May, 1922.
O Thoreson
Notary Public, Jackson County, Minn.
My Commission expires Jan. 15th 1927.


Affidavit of C. M. Tradewell (23 May 1922). Image courtesy of Verla Williams.

The text of the above affidavit is identical to that of James Rost above.