Department of the Interior,
Bureau of Pensions,
September 28, 1889.

No. 401,091, Mother
Samuel Allen
B. 12, W. Va. Inf.

     Sir:
     I have the honor to request that you will furnish from the records of the War Department a full Report as to the service, disability, and hospital treatment of Samuel Allen, who , it is claimed, enlisted Aug. 20, 1862, and served as not stated in Co. B, 12 Reg't W. Va. Inf.; and was discharged at not stated, 18--.
     While serving in Co. and Reg't as above he was disabled by disease of lungs, died Feb. 24, 1863 and was treated in hospitals of which the names, location, and dates of treatment are as follows: not stated

If soldier was a deserter, please state whether the charge of desertion can be removed.

Very respectfully,
James Tanner
John C. Black,
Commissioner

War Department
Record and Pension Division,
Washington, D. C., Sep. 30, 1889

401,091
     Respectfully returned to the Commissioner of Pensions Samuel Allen Pvt. was enrolled on the 12 day of Aug., 1862, at Moundsville, Va., in Co. B 12 Regiment of W. Va. Volunteers, to serve 3 years, or during the war, ............ he is reported on roll of Co. coming from Aug. 20 to Oct. 31/62, "absent at home in Marshall Co., Va. on sick leave." Nov. & Dec./62, same. Final Statements show "Died of Consumption at home Marshall Co., Ohio, Feby. 24, 1863."

Affidavit in Father's or Mother's Claim

Single Affidavit
     I, D. B. Hill, of lawful age, a resident of the County of Marshall, in the State of West Va., upon my oath declare that I am, and have been for several years, intimately acquainted with Elizabeth Allen mother of Samuel Allen, deceased, late a private in Company B in the 12th Regiment of Wt. Va. Inft., commanded by Col............ in the War of 1861, &c. That I was also personally well acquainted with the said deceased in his lifetime. That he died unmarried, leaving no widow, child, or children as his heirs surviving. That his mother is also dead (error - should read, father is dead). That I am now, and have been for 35 years, personally acquainted with said soldier's mother, and know that she is without other present means of support than her own labor.
     That she has one third interest for her natural life in a farm of about seventy-five acres left by her late husband probably value of said farm about forty dollars per acre.
     That the said Elizabeth Allen, mother of the above-named soldier, deceased, is now a widow, and has been such ever since the 8th day of March, 1860, at which time David Allen, her husband, died in the County of Marshall, in the State of Wt. Va.
     That the said Elizabeth Allen lives with her son-in-law who resides on the above mentioned seventy-five acre farm, situated in the County of Marshall, in the State of West Va., and which property is owned by Davied Allen's Heirs in whose name the title thereto vests, and which, together with the improvements thereon, is of the value of three thousand dollars. That this property is totally inadequate to the support and maintenance of the said Elizabeth Allen. That she neither owns nor has in use any other property, real, personal, or mixed, from which a revenue can be derived. That she, has no source of income, save and except what she may be enabled to earn by her own exertions, except what she received from her interest in the aforesaid farm.

Declaration for Dependent Mother's Pension.
State of West Va.
County of Marshall, SS:

     On this twenty-second day of November, on thousand eight hundred and ninety, personally appeared before me Wm. R. Crow, a justice in and for the County and State aforesaid Elizabeth Allen aged 72 years, a resident of the County of Marshall State of W. Va. who, being duly sworn according to law, declares that she is the mother of Samuel Allen who was enrolled under the name of Samuel Allen at West Virginia on the 20th day of August, 1862, in Co. "B" - 12 W. Va. Vols. in the War of the Rebellion, who died near Pleasant Valley, W. Va. on the 24th day of February, 1863, from the effects of consumption incurred at Buckhannon, W. Va. on the ....... day of October, 1862.
     That said son left neither widow nor child under sixteen years of age surviving. That there were surviving at said son's death his brothers and sisters, as follows:
John Allen, born July 14, 1838;
Virginia Allen, born April 14, 1846;
Mary Isabella Allen, born June 15, 1848;
David R. Allen, born November 26, 1855;
Allice Allen, born July 10, 1858
     The number of her claim is 401,091.

Elizabeth Allen
(Claimant's Signature)

     Also personally appeared James M. Blair residing near Pleasant Valley, W. Va. and George W. Livingston residing near Pleasant Valley, W. Va. persons whom I certify to be respectable and entitled to credit, and who, being by me duly sworn, say that they were present and saw Elizabeth Allen, the claimant, sign her name to the foregoing declaration; that they have every reason to believe from the appearance of said claimant and an acquaintance with her of 40 years and 16 years respectively, that she is the identical person she represents herself to be; and that they have no interest in the prosecution of this claim.

James M. Blair
Geo. W. Livingston
(Signatures of Witnesses)

For Affidavit of Officer or Comrade.      In the Pension Claim No. 401091 of Elizabeth, mother of Samuel Allen late a ........ in Co. "B" of the 12th Reg't. of W. Va. Vols. personally appeared before me, a ............. in and for the aforesaid County, duly authorized to administer oaths Martin Whetzal aged 56 years, a resident of Limestone in the County of Marshall and State of W. Va. who being duly sworn according to law, states that he is acquainted with Elizabeth Allen applicant for Mother's Invalid Pension, and knew the said Samuel Allen to be the identical person of that name who enlisted or volunteered as a ................ in Company "B" 12th Regiment of W. Va. Vols. and who died at Pleasant Valley, W. Va. on or about the 24th day of February, 1863, by reason of lung disease.
     That the said Samuel Allen while in the line of duty, at or near Buckhannon in the State of W. Va. did, on or about the ...... day of September 1862, become disabled in the following manner, viz.:
From exposure while suffering from mumps he contracted lung disease and was weak and debilitated.
     That the facts are personally known to the affiant by reason of being present at the time and place aforesaid when soldier contracted the above mentioned disability, hearing him complain and seeing him affected by the same and from having served as private and corporal in soldier's Company.
     And deponent futher states that he was well acquainted with the soldier having known him since boyhood and further, that his knowledge of the facts above stated is derived from said aquaintance, and from having served as Corpl. of Company "B" of the 12th Regiment of W. Va. Inft. Volunteers, from the 13th day of August 1862, to the ...... day of June 1865. And deponent further states that the soldier was a sound and able-bodied man at and prior to enlistment, so far as he knew, and that he is totally disinterested in this claim.
     Post office address of affiant is Limestone, Marshall Co., W. Va.
Martin Whetzal
(Signature of affiant.)

State of West Virginia, County of Marshall, SS:
     Sworn to and subscribed before me this 18th day of May, 1891.