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Transcribed and submitted by Linda Talbott
from copy of record provided by Jeanine Witherell-Eaves
for the US Data Repository http://www.us-data.org/
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Formatted by U.S. Data Repository Chief Archivist, Linda Talbott
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                     AFFIDAVIT TO ORIGIN OF DISABILITY
                              ____________
                              
To be executed by an officer or enlisted man of the soldier's company and
    regiment having personal knowledge of the circumstances which the
     disability was incurred on account of which pension is claimed.
                              ____________
                              
    Before filling in this Affidavit the Witness sould read carefully
    the Marginal Instructions, and conform thereto in every particular
    as far as his knowledge of the facts will allow.  Enlisted Mens's
    evidence will not be accepted if an Officer's can be had.
    
State of New York   }
County of Livingston}SS:

        In the matter of the Pension claim of Isaac H. Witherill
      Priv, Co B., 136 Reg't N.Y Vols, personally came before me,
      a Notary Public in and for the aforesaid County and State,
      H. Chamberlain, of Mt. Morris, County of Livingston, State
      of New York, who, being duly sworn, declares in relation to
      the aforesaid claim that his age is 50 years; that he is the
      identical person who served as a Private in Co. F, 136 Reg't
      N.Y. Vols; that on or about the 3d day of July, 1863, while
      in the line of duty, and without fault or improper conduct
      on his part, at or near Gettysburg, State of Pennsylvania
      said soldier incurred a shell wound on the right side of
      the head under the following circumstances, deponents com-
      pany was color company at the battle of Gettysburg, & said
      Isaac H. Witherill was one of the color guard.  That deponent
      was in line of battle with the company & near said Isaac H.
      Witherill who stood with the color guard - deponent saw a
      shell explode in the midst of the color guard & saw said
      Witherill struck to the ground & lay there, having been
      struck by a piece of said shell - deponent afterwards saw 
      said Witherill carried to the rear & saw where he was
      wounded by the piece of shell on the right side of the
      head - & deponent knows of his being treated for said in-
      jury afterwards a number of times by the regimental sur-
      geon - * knows of his complaining frequently of said in-
      jury afterwards, causing as he said worse headaches,
      nearly all the time.
        Deponent knows the foregoing facts - from having been
      an eye witness of said occurrance - & of the effet of the
      injury - from having talked with said Witherill about it.
      
      Affiant further declares that he has no interest, direct
      or indirect, in this claim, and that he makes the above
      statement from personal knowledge.
      
      Affiant's Post-Office address is as follows:
      Mt. Morris, Livingston Co., N.Y.
                                   H. Chamberlain
                                   
     SWORN TO AND SUBSCRIBED before me this 19 day of January
     1889, and I hereby certify that the contents of the fore-
     going affidavit were fully made known and explained by me
     to the affiant before swearing thereto, including the words
     _____________________ erased, and the words ______________
     added, that the affiant is well known and entitled to 
     credit; and I further certify that I have no interest
     directly or indirect, in the prosecution of this claim.
                                   Jno Hasting
                                   Notary Public
                                   
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Transcibers Note:  The surname is incorrectly spelled as Witherill
                   throughout this document.  The correct spelling
                   is Witherell as is found on many other documents.