Form No. 3
                        Application of Widow 

I, Aggie Stapleton, widow, do hereby apply for aid under the act of the 
General Assembly of Virginia, approved April 2, 1908, entitled an 
act to aid the citizens of Virginia who were diabled by wounds
recieved during the war between the states while serving as soldiers,
sailors, or marines of Virginia, and such as served during the said
war as soldiers, sailor, and marines of Virginia, who lost their 
lives in said service, or whose death resulted from wounds recieved
or disease contracted in said service, and providing penalties for
violating the provisions of this act, and I do solemnly swear that I
am a citizen of the State of Virginia resident at- Adamson-, in
the county of- Scott- in the said State, and that I have been an actual
resident of the said State for two years, and of the said city (or
county)for one year next preceding the date of this application, and
that I am the widow of -John Stapleton Sr.- who was a soldier( sailor
or marine) in the service of the State of Virginia, in the war between
the States and who was a member of( here state specifically the command
and branch of service to which the husband of the applicant belonged and
if possible, the names of his immediate superior officers)-1st Regm. VA
 __? Vols. Company Offs. (unreadable)_______________________________?
and who while in the discharge of his duty in the military or naval
service of the State of Virginia or of the Confederate States during the
said war, lost his life( if the husband of such wife was killed or died
during the war as a result of wounds recieved, state the facts of the
cause as near as possible, giving the date of the husbands death-__
(left blank).
(If the husband died after the war, strike out all relating to his death
during the war, and then proceed as follows:)and who has since the
war died( here state specifically the name of the death of the husband
of the applicant and the date thereof)John Stapleton (unreadable) and 
that to the best of my knowledge my husband was loyal and true to his
duty, and never at any time deserted his command or voluntarily 
abandoned his post of duty, and that I was never divorcedfom my said 
husband, and that I never voluntarily abandoned him during his life,
but remained his true, faithful and lawful wife up to the date of his
death, and that I am a widow at the date of making this application,
and that I am entitled to recieve, under the said act the sum of 
Twenty Five dollars annualy. And I do futher swear that I do not hold
any position or office either national, State, city or county which
pays me a salary or fee Two hundred per annum; nor have I an income
recieve from any other employment or other source whatsoever which
amounts to Two Hundred dollars per annum; nor do I recieve from any source
whatever money or other means of support amounting in value of the sum
of Two Hundred dollars per annum; nor do i own by my own right, nor does
hold in trust for my benefit, or use estate or property either real, 
personal or mixed, either in fee or for life, of the assumed
value of Seven Hundred and Fifty  dollars; nor do I recieve any aid 
or pension from any other State, or from the United States, or from any
other source, and that I am without means of support, direct or indirect;
and I do further swear that the answers 
given to the following questions are true:
1. What is your age?  Ans -I am 78 years old
2. Where were you born? Ans- In Scott Co. VA
3. How long have you resided in Virginia? Ans- All of my life
4. How long have you resided in the city or county of your present
   residence? Ans- All of my life
5. What is your husbands full name? Ans- John Stapleton Sr.
6. When and where were you married, and by whom? Ans- Jan. 1855. 18 
   mar. by Jasper Pendleton __?
7. When and where, as near as you can state, did your husband die,
   and from what cause? Ans- In 1878 from (unreadable)
8. Have you married since the death of your said husband? Ans- No
9. Where and with whom do you now reside? Ans- In Scott Co VA with
   (unreadable)
10. What property-real, personal or mixed-do you own? Ans- None whatsoever
11. What maintence do you recieve, and what income have you from any
    source? Ans-(unreadable)
12. If your husband died since the war, please state where he died and,
    if possible, the name and address of the attending physician. 
    Ans-(unreadable)
13. Give the names and addresses, if possible, of two comrades in arms
    of your deceased husband. Ans- Mr. M. Nickles Jr. & Russell Marshall
    Scott Co.,VA
14. Give the names and addresses of two persons who are familiar with the
    circumstances of your husbands death. Ans- Mrs. J. Cort & E. E. Ramsey
    (unreadable) VA
15. If your husband died since the war, please state whether his death 
    resulted from wounds recieved in the war, or from what disease.
    Ans- From disease and (unreadable) illness
16. Give as near as you can, the nature of the wound or the character of 
    the disease from which your husband died. Ans-(unreadable) and kidney
    discharge 
17. Give here any other information you may pocess relating to the service
    of your husband or of his death that will support the justice of your
    claim for aid. Ans-The Dr. did all he could (unreadble)
18. Is there any camp of Confederate Veterans in the city (or county) of
    your residence? Ans- Yes at Gate City,VA
19. Is there anyone living, the residence and address of whom is known 
    to you, either comrade or otherwise, who has knowledge of your 
    husbands service and of the cause of his death? If so or note, state.
    Ans-  F. McBride(unreadable)

Given under my hand this the 4th day of May 1908
                                 Aggie Stapleton

I, John A. Moore, a Justice of the Peace in and for the County
of Scott, in the State of Virginia, do certify that Aggie Stapleton,
whose name is signed to the foregoing application, personally appeared
before me in my county, aforesaid having the aforesaid application
read to her and fully explained, as well as the statements and
answers therein made, the said Aggie Stapleton made oath before me 
that the said statements and answers are true.
                                 John A. Moore J P
                                             

                  (A)
        OATH OF RESIDENT WITNESSES
We, B. J. Stapleton and Thomas J. Stapleton, do solemnly swear
that we are residents of the County of Scott, in the said State,
and that we have known personally and well for 40 years,
Aggie Stapleton, whose name is signed to the annexed application
for aid under the act of the General Assembly of Virginia,
approved April 2, 1902, and that the said Aggie Stapleton, is a
resident of the said county ( or city), and is a woman of good
reputation for truth and honesty, and that we have read the
annexed application and the answers to the questions therein
propounded, made by the said applicant, and verily believe
that the said applicant has been truthful in the said statements
and answers, and that from our personal knowledge we believe that
the applicant is justly entitled to aid under the said act, and
that we have no personal interest in the allowance of the 
applicant claim. 
                                              B_____ J. Stapleton
                                              Thomas J. Stapleton