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What is your name?: Herbert [Scott?]
What is your age? (years): 18 8 17
What is your occupation?: Farming
Where is your residence?: Wolftown, Madison, Co, Va.
Where were you born?: Wolftown, Madison, Co, Va.
Are you married?: no.
What was your wife's name before marriage?: no wife
Are you married to more than one woman?:
Have you children?: no
Do your wife and children enjoy good health?:
Are you sound in body?: yes
Are you subject to any periodic complaint which is liable to render you unable to follow your usual employment, or which is calculated to shorten life, and thereby render yourself, wife, and children a burden to this Lodge?: no
Will you faithfully obey the laws and submit to all the penalties that may be imposed, should it ever be proved that you have made a false statement?: yes.
Dated: Aug. [2?], 1919.
Signed : Herbert Scott.
Witnessed: :
Witnessed:
34
What is your name?: Ed. W. Barbour
What is your age? (years): 26
What is your occupation?: [illegible][hofer?]
Where is your residence?: Madison
Where were you born?: "
Are you married?: Yes
What was your wife's name before marriage?: [Conealus?] Price
Are you married to more than one woman?: no
Have you children?: yes
Do your wife and children enjoy good health?: yes
Are you sound in body?:
Are you subject to any periodic complaint which is liable to render you unable to follow your usual employment, or which is calculated to shorten life, and thereby render yourself, wife, and children a burden to this Lodge?: no
Will you faithfully obey the laws and submit to all the penalties that may be imposed, should it ever be proved that you have made a false statement?: yes
Dated: July 23 1920
Signed :
Witnessed: : L.B Alexander
Witnessed: Chase [Slaughter?]
