State of North Carolina,
County of   Rockingham
 

On this 22  day of    July           A.D. 1904   , personally appeared before me,  J A Gibson  J.P.    , C. S. C., in and for the State and County aforesaid,   H. W. Wrenn   , age   61    ,years, and a resident at  Ruffin, N.C.    post-office in said County and State, and who being duly sworn, makes the following declaration in order to obtain the pension under the provisions of an act entitled "An Act to amend chapter 332 of the Laws of 1901,  for the relief of certain Confederate Soldiers, Sailors and Widows," ratified March 2, 1903: That he is the identical     H. W. Wrenn  who enlisted in Co.   B    ,   4th  Calvary   Reg. N. C. State Troops, on or about the  1 st             day of  June       ,  1862 , to serve in the armies of the late Confederate States, and that while in said service at                                               ,    in the State of ______________________ , on or about the  ______ day of ________,186__he received a wound or wounds, etc.
(Applicant will here state the nature and extent of his wounds and disability, so that a proper classification can be made under the new Pension Law passed by the General Assembly of 1901. Read said section of said law carefully, and to accomplish the classification therein called for, let statement here as to nature and extent of wounds, disability, etc., be very full and explicit.)

             I have the leader in my right - foot
             broken and in walking it hurts me.
             Have ingenial hernial and it is very hard
             to keep up.  Have had rhumatism for the
             last five years and suffer a great deal
            with it in winter.  Have kidney
             trouble and have to get up 7 to 10 times
             a night and not able to work more than one
             fourth of my time.

He further states that he is , and has been for twelve months immediately preceding this Application for Pen-
sion, a bona fide resident of North Carolina; that he holds no office under the United States, or under any State
or County, for which he is receiving the sum of three hundred dollars as fees or as salary annually; that he is
not worth in his own right, or the right of his wife, property at its assessed value for taxation to the amount of
five hundred dollars ($500), nor has he disposed of property of such value by gift or voluntary conveyance since
the 11th of March, 1885, and that he is not receiving any aid from the State of North Carolina or under any
other statute providing for the relief of the maimed and blind soldiers of the State.

Sworn and subscribed before me, this  22 day of July 1904
H.W. Wrenn
Signature of Applicant

J.A. Gibson  J.P.
Signature of C.S.C.

      Also personally appeared before me     John W. Fitzgerald        , who  resides at  Ruffin     post-office, in said County and State, a person whom I know to be respectable and entitled to credit, and being by me duly sworn, say he is acquainted with    H. W. Wrenn      , the applicant for pension, and has every reason to believe that he is the identical person he represents himself to be, and that the facts set forth in this affidavit are correct to the best of his knowledge and belief, and that he has no interest, direct or indirect, in this claim.

     Sworn and subscribed before me, this     22  day of July, 1901

John W. Fitzgerald
Signature of Witness

J.A. Gibson J.P.
Signature of C.S.C. }

     Also personally appeared before me   C. R. Wharton     a physician in good standing in said County and State, and being duly sworn, says that he has carefully and thoroughly examined    H. W. Wrenn       , the applicant for pension, and  finds such disability for manual labor as is described below, by reason of wounds received while in the discharge of his duty as a soldier or sailor of North Carolina in the service of the late Confederate States.
(Let physician here give full and explicit professional information as to the nature and extent of wounds, disability, stating particularly whether disability amounts to one fourth, one half, three-fourths, etc., in order to accomplish the classification called for under the new Pension law passed by the General Assembly of 1901).

             I have the leader in my right - foot broken
             and in walking it hurts me.   Have ingenial
             hernial and it is very hard to keep up.  Have had
             rhumatism for the last five years and suffer a
             great deal with it in winter.  Have kidney trouble
             and have to get up 7 to 10 times a night to pass
             my water
 

    Sworn and subscribed to before me, this    22 day of July, 1904
C. R. Wharton
Signature of Physician

J.A. Gibson J.P
Signature of C.S.C.
 

STATE OF NORTH CAROLINA, }
                    Rockingham         County.      }

To the Auditor of the State of North Carolina:

     We certify that we have carefully examined the application of   H. W. Wrenn   for a pension under the provisions of an act entitled "An Act to amend chapter 332 of the Laws of 1901,  for the relief of certain Confederate Soldiers, Sailors and Widows," ratified March 2, 1903,   and the proofs filed in support thereof; that we are satisfied the said    H. W. Wrenn      is the identical person who enlisted in Company   "B" ,    4     Regiment of  N. C.  Troops, on or about the    1      day of  June          186 2   , and who was disabled in manner and to the extent stated in the foregoing certificates of himself and physician in consequence of a wound received in battle on or about the ______ day of                  186__ , and we certify the following allegations set forth in his application to be true, namely: That he is, and has been for twelve months immediately preceding this Application for Pension, a bona fide resident of North Caro- lina; that he holds no office under the United States, or under any State or County, from which he is receiving the sum of three hundred dollars as fees or as salary annually; that he is not worth in his own right, or the right of his wife, property at its assessed value for taxation to the amount of five hundred dollars ($500), nor has he disposed of property of such value by gift or voluntary conveyance since the 11th of March, 1885, and that he is not receiving aid from any other source for the State of North Carolina, and therefore his application is correct and just under the act.

                                                                   {Seal} Jas N Price

{IMPRESS COUNTY SEAL HERE}
                                                     Approved:   E. R. Harris
                                                                        A. F. Neal
                                                                        J. H. Lane
                                                                                       County Pension Board.

        Flap on Front of Folder
SOLDIER'S APPLICATION FOR PENSION
           Act of March 2d, 1903
========================
        H. W. Wrenn
who enlisted in Company   "B",   4
Regiment North Carolina State Troops.
 

(STAMPED)

DISALLOWED S.B.P.
INSUFFICIENT DISABILITY

========================
Filed by Board of Inquiry of
County, N.C.,          day of                    ,
190