(This form will be used both in final homestead proof and commutation proof.)
TESTIMONY OF CLAIMANT.
, testifies as follows:
Ans. Dugland Campbell
Ques. 2. What is your age?
Ans. 60 years
Quest. 3. Are you the head of a family, or a single person; and, if the head of a family, of whom does your family consist?
Ans. I am married and have one child
Ques. 4. Are you a native-born citizen of the United States? If not, have you declared your intention to become a citizen, and have you obtained a certificate of naturalization?*
Ans. I am foreign born. Have been naturalized a citizen of the United States.
Ques. 5. Are there any indications of coal, salines, or minerals of any kind on the land embraced in your homestead entry above described? (If so, state what they are, and whether the springs or mineral deposits are valuable.)
Ques. 6. If the land more valuable for agriculture than mineral purposes?
NOTE.-At the time of making proof that party should be required to surrender his original homestead duplicate receipt, or file an affidavit accounting for same.
*In case the party has been naturalized, a certified copy of his certificate of naturalization must be furnished. In cases of commuted homesteads it is sufficient if the party has declared his intention to become a citizen, in which case a certified copy of his declaration of intention must be furnished.
Ques. 7. What is your post-office address?
I HEREBY CERTIFY that each question and answer in the foregoing testimony was read to the claimant before he signed his name thereto; and that the same was subscribed and sworn to before me this 19th day of November , 1879.
NOTE.-The officer before whom the testimony is taken should call the attention of the witness to the following Section of the Revised Statues, and state to him that it is the purpose of the Government, if it be ascertained that he testifies falsely, to prosecte him to the full extent of the law.
SEC. 5392. Every person who, having taken an oath before a competent tribunal, officer, or person, in any case in which a law of the United States authorizes an oath to be administered, that he will testify, declare, depose, or cerify truly, or that any written testimony, declaration, deposition, or certificate by him subscribed is true, willfully and contrary to such oath states or subcribes any material matter which he does not believe to be true, is guilty of perjury, and shall be punished by a fine of not more than two thousand dollars, and by imprisonment, at hard labor, note more than five years, and shall, moreover, thereafter be incapable of giving testimony in any court of the United State until such time as the judgment against him is reversed. [See § 1750.]
Note: Handwritten entries on the form are indicated by bold italics .
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