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'd-,.'r.f 'ti118-'Q:villloat~On:Bhali:~ot'.ijJ ,ao~ept'~dl ~<\,ap\pk'OVed ~s'bere1h ~rovlded fth~ sake ~he.ll ! \,'1 \ '
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" II b~ vo,~ and ~~1d~~!,~A1Ty'8hnlloano~t\ 'c.n~.i ret~il\ ,to ,~e salf1::,ln~ere,stl. po,te h~r~Y'l~hl det,iv,red.:; \ >~ ;,
"T:=-~---' l'ill{lW-on rAY -P~~\to-gtv.eJ41.a:.1fi'nlfef;lt..\IlhteP" O~y'-or--;t-hem';-\e.a:nern~p~Yraed~:--or~-=t~:- ',: ':,' -
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;" pay theSa.m~ ,~r. _~Y'_Rf'4f1~,IIl,_J7~~n,d'-le.. ,'Qr. t.Q -_P~Y.,,~t], \ flaJ.d t.'Afee \71;e~ ~ue ~ lor tQ .e~e~O~Il!;l ,J)J\~~, '
l' OOlllP~Y\'/1tb,sotne\one'or\t10re\ ot the'altet-na\t1~~ ~rov\~s~j)~ hereo~i-.e~t1tl,lng 1l1~',to''a,~e~d ,to ,"1;
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t, 'eald la~d'\'~ithln \ the t1me~ere1i1 spe\ol~led 'tor OOlXlplle..n~e,' therev~1t~,~ shall a'bsql\itely terml1i~ te
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all lIlyr1g}l.ts~ereunt\e1" 'and 1n~ereB1;, fn and toth.e \land' above &.esorl:Ded" and ~ll1.m>>rovem.ente, . 'i
,tlle~e~n", a~:fUtlY a's tho~'~htS:W~i;t'~rt8Jl1 neve~ eX1~t~d\Vllt'h~t anyn~tioe,to ~e'orto' ~ d,'
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-legal'representat1ves, notloe being hereb1 e.xpr.asly walved. and wi t}lQut ,&17 legal aotion 'or,
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, prooeed1ng, on, the part ,o~ Bald' ,CPl&PAliY, ,and I agre,~' to y'~eld lnunedj.9;te and Iie8geablT, ,possess1on .'
~t' :~a~d;land"'~d',1.m~~~em~~h and e~erY'.r~rt th~re6f.:b~t.l.~'~i~ not. th~reb1be- ~~-i~end' ~;,o~'. ' . ,
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payIaent ot, ant ~l', ,sa!ll., ,1-literea1i:nQ testheretofQ~ exeouted ahd de11vere,d-, tne 'uionqsev1~enoed, '
"by-~,~1d.:note'9~ ~ote(i._~b,e1Dg1nthatf 'e'ven~ ,~~~1Jl~4 'paytne~t,;.t~r'ih~' '~use'9t ~a.1~' l:and ',:,' '
" " ,I aooe1>t' ~~' aOkn~,ir~ th~_ ag~nt '~r,8,0l1Cl~Or:-80i1oit~"and.1t~lng th~~,ap~110~t1C1l. ~8',
'mY p.geni aB \'~eli, as' t~e' agent 'o't'Bald 'C,OltPAifY,'and' 1 ,und~:fatarici~d- ~~ee 'th~tsaid. &g$nt ~r_. '
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s9~'l.o1tq:, halino power' ~r authprity to;b:LndBald COLfi>AllYby'a:ny' rei>re~entatlWn" 'arrang:eill'ent'or,
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Qgreeine'n't',c'~x~eJ?,t 'suoh ~8;are ,here,th",exP"~s~11' set'~orthi a~d,i~,l!16kllig this appll~ll.t~~n an~' ' ,.
agreement, I am r~lylng solely' upon my' O\7n InfO'rmation~a.nd' 1nv~s tig'e:t1on,'- and upon the' prl'nted" ,
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Hterat~e ot (lai,~ COJ.\:P..ALW rela,t'tng ,t()..sald.1e.nd,wid~.J1~~t upC?n '~ oral repreientati,on'or a,tate-
_menk'~f a~ pe~~~ w~msoev~~. ' ,." '
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.. ~ 'a ~ondltlo,n, of ilnd: aoo~~14eraUon for the'
(lal~ ~,01{PAllt. I, he,reby mfike7'the,',tol19\11i1gst~~e~ents'
'1; 'll3' age 1s 37 years~'
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8.o0el.>tal,lce ,and ,approva'l' of ,this ,~p:pl,j,CJatril ~1
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and.'vlarra.nt tie (I~ ,to' be true,:"
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2.' , ).at,1onality 'Am~r,1'0an.. ' '\l1ll. te ..
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,3.. O~~up,~tlonDO?t,oro:r)'{~d1oi.~e; >
',.4'.' 'Marrlel ("Yea or iio) l{o,'
, 6. ' 1 'haVe 'no ohildi-en~
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6., 'll3",Wll'e's riame~~H!' '
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'1~ I belong ,to ,Babtlst Churoh.,
e.. ',I belong to the to 11 0\:11 ng ,fra~~~e,lorderS:1' & :A.lt,:. II~O.W., A.A.O:N.X. '5.
9. ',1 o~rY.13,OOO. lite Ipsuranoe: in' tollov/1ilg o~pEl.~e8:U.S., Go,v." W~O.W'. }.{aoot!.l"~es
Columbian. '
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10. ,1 own'realeet'a'~e a~Jtollo\'i8(2 lobS. l~tlrSt.',
11., ~8lllti. 1Benoumrred fO~ $14:?O~.he,l.d,bl,I~' ~.' Waters'
12. "I ow.n $1800.00, worJiJiotper80nal propertl. ' .
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,13. -I ,OVl~ debts ot $l~OO. oon11St1ng of 900AOO Uortg&l$e, & tiOO.OO ,l;o.;n' above prop'erty. ~
.1.'. My net' wo~th ls$adOO.oo.' ,', ...,' '.' '" " " ,
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16~ There are nos~l~,s pe~d1ngor3u~em.ntB aga1nst'me (3xoept !ione. .
16, 'Do you-1nt-end to set\leon tb,e land you }:lave appl1ed for? Ittend to ,improve.
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17.,
Give ,baDkreterenoe: St. Luci1e Coun.ty B~.'
1\-
~ bank acooU; is lnnameotL. H. Dame
I am now In good health andl havonot nO\'1 , nor have I ever hantl any'disease of tqe, .
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,tollowing namell.organs Or any ot the follo\lilna named d1;seaseB: A~oplexj. Brlght's Disease, '
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Bl-a1n, Canoer,CownUllpt'1on, D1abetes, Epliep,y, Hear, XidneYD~seaBe,'L\U1g8 or Paralysis,
eXOf)pt~.; .Hone....,
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IN WITNESS \1lEREOF, , I' 'hAv" hereunto ~subsor1 bed my name this 6 !1AY of )(arah 1920.
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Thl-sappl.1catlon is aooep'ted arid approved this
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6th day ,ot Uaroh, 1926.
I 1liDU.lf RIVER OWIGE 8;, TaUCK Ull'D3 'COKPAllY '
B7 lToeeph 1. Re1a
L. H. Dame
----"ppl'lcant.":'~.~-- ,----~,
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ff1tilellll ;
E. E. Fisher
Sbl101tor.
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