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FORM NO. 20.

Quarterly return of the number and rating of the crew of the U. S. S.

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term of service expires in each month.

Year.

Month.

The number whose term of service expires in each month.

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Officers

Petty officers.
Seamen..

Ordinary seamen
Landsmen
Boys...
Firemen
Coal-heavers
Musicians.
Marines.

Paymaster.

FORM NO. 21.

Return of persons enlisted at the United States Naval Rendezvous, during the week ending at the hour of closing, Saturday, 18—.

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testimonial of fidelity and obedience," is this day "honorably discharged" from the United States

and from the naval service of

the United States. Now, according to the provisions of the second section of the act approved March 2, 1855, if within three months from this date the above-described shall present this

his "honorable discharge" at any United States naval rendezvous, and if found physically qualified, and shall re-enlist for three years or longer, then he shall be entitled to pay during the said three months equal to that to which he would have been entitled if he had been employed in actual service.

Approved:

Commanding Officer.

Paymaster.

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SIR: I have examined, [state the name in full,] who states that he was born in, [name of town and State,] on the

day of

18-, and find that he is [not] physically qualified to perform the duties of a [name the grade] in the Navy of the United States, [if not qualified add,] because he has [state the disability.] I am, very respectfully,

To

Commanding U. S. Naval Station.

Surgeon.

FORM NO. 25.

Commanding Officer's report of death or disability in line of duty to establish claim for Pension.

U. S.

SIR: I have to report the [death or disability] of

18-.

a

in the United States Navy, while serving under my command. The [death or disability] of the above named

occurred on the in the line of duty.

day of

18-, [here state where] and

[Here state briefly, but clearly, the facts known to Commanding Officer, as to circumstances attending the death or wounding, or other cause of disability. When the facts are not known by Commanding Officer, give an abstract of the statement of an officer or other person having knowledge thereof. When death or disability occurs from disease alone, give the opinion of the Medical Officer, as to the origin of the disease. But in all cases the Commanding Officer will distinctly state his own opinion whether the person was or was not in the line of his duty at the time of his death, or when he received the wound or injury, or contracted the disease producing his death or disability.]

[Here add as may be proper.]

I inclose herewith the report of Surgeon

as to the nature

in refer

and degree of the disability (or as to the origin of disease, if necessary) in this case, and (if requisite) the statement of ence to the cause of death, or origin of wounds or injury, producing disability.

Very respectfully, your obedient servant,

Hon.

Commanding United States

Secretary of the Navy.

NOTE. In all cases where testimony other than the personal knowledge of the Commanding Officer is requisite, such testimony will be taken in writing, and in triplicate. Will be signed by the officer or other person making it, and approved and forwarded by Commanding Officer with his report.

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United States Navy, serving under your command. He died on the 18-, [here state where] of (casualty, disease,)

day of

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as set forth in the record of his case, as follows:

[Here state briefly but clearly the facts as to cause of death; if the death has occurred from disease alone, state the original cause of disease, and the time when incurred as exactly as may be practicable.]

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States Navy, serving under your command, is disabled by (disease

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