CA1304

Application For Adjusted Compensation by family of Charles Rudd
(C. Avis Catalog entry #1304)
(Document ID #305)

[Note:  this document is unsigned - perhaps a draft or maybe never submitted - ca]


WWC Form No. 1
APPLICATION FOR ADJUSTED COMPENSATION FOR SERVICE IN   Army


This application must be sent to the War Department, Navy Department, or Marine Corps, as
indicated in instructions, depending on whether your last service was in the Army, Navy, Coast Guard,
or Marine Corps. Use the envelope provided for this purpose, with the proper address printed on it.

READ INSTRUCTIONS OVER CAREFULLY

To the Secretary of War or Secretary of the Navy.
The following statements are made by me in support of my claim for Adjusted Compensa-
tion under the provisions of the World War Adjusted Compensation Act:

Item
No.
1. Name of veteran:
    Rudd Charles Maples         Service or Serial No. 1193064

2. Present address of veteran or dependent  916 South 1st
    Temple    Bell    Texas

3. Date of birth of veteran  June 20 1895  at Temple Texas

4. Original entry into World War service in the Army, Navy, Coast Guard, or Marine Corps
was as a   Private 1st Class    on  March 9 1918

5. Date of separation  November 12 1919  at  Killed in aeroplane accident near Stockton California

6. I did (did not) have oversea service.
 
7. Service in organizations, at stations or on vessels in the order named as follows :
 
School Military Aeronautics Austin Texas   from  March 9 1918  to  June 4  1918
Rockwell Field S.C.A.S. San Diego, Cal       from  June  7 1918    to  Aug 17  1918
Mather Field, Sacramento, Cal                   from  Aug  17 1918   to  Nov [?] 1918
Rockwell Field, San Diego, Cal                   from  Nov   5 1918    to  Aug 30  1919
Mather Field, Sacramento, Cal                   from  Aug  30 1919   to  Nov 12  1919

8. Character given on discharge certificate

Item 9 will be filled in only by men whose service or part of whose service was in the Marine Corps

9. Embarked for oversea service on -


Item 10 will not be filled out in case of dependent making application Application

10. In accordance with the statements made by me in this application, I hereby apply for the
benefits to which I may be entitled under the provisions of the World War Adjusted Com-
pensation Act, and designate the following-named person as my beneficiary under the pro-
visions of said set: 

Name
Address of beneficiary
Signature of veteran

11. Fingerprint of right hand of veteran 

12. (See instructions for this item.)

(a)  Name:  Rudd Chas Maples
(b)  Serial No.:  Army 1193064
(c)  Address:  Deceased
(d) Date of Birth:  June 20 1895  Temple Texas
(e) Rank and organization:  Second Lt. Army Air Service  91st Aero Squadron


13. Commissioned service:    GRADES    FROM-           TO-
                                               2nd Lt    Oct 25 1918    Nov 12 1919

14. I was a commissioned or warrant officer performing home service not with troops and receiv-
ing commutation of quarters or of subsistence from _
to _ and during this period I was on duty at the following
stations: 
    None

15. I was granted a fan or industrial furlough from _ to _

16. I (was not) a conscientious objector who performed no military or naval duties what-
ever, and did (did not) refuse to wear the prescribed uniform of the branch of service in
which I was serving.

17. I (was not) discharged for alienage.

18. Remarks:

19. I certify that I am the  Mother  named in this application;
that the statements made herein are made by me of my own free act and deed for the
purpose of applying for Adjusted Compensation under the provisions Of the World War
Adjusted Compensation Act; and that the same are true and correct to the best of my
knowledge and belief.
    Date
    Signature of applicant _


Item 20 will not be filled in when dependent makes application

20. We, the undersigned, certify that we know the person signing the application to be identical
with the veteran whose service is set forth in the above application, that we have known
him (her) for _ years and _ years, respectively;
and that he (she) understands the statements made by him (her) and the penalty provided
by law for making false statements.

Signature of witnesses: 
 


Dependents must be sure to submit with their application the affidavits as shown in the instruc-
tions which are required by law and regulations.

The following items will be completed only when dependent makes application for compensation

21. At the time of his death the veteran named in this application had the following-named
dependent relatives now living :

1. Widow or widower  __

2. Child  __

3. Mother    Maggie Mooring Rudd

4. Father __

22. I am  Mother  of the veteran named in this application; I was
a dependent of him at the time of his death, at which time I was 50 years
old, and in accordance with the statement made by me in this application I hereby
apply for the benefits to which I may be entitled under the provisions of the World War
Adjusted Compensation Act.

23 My address is   916 South 1st  Temple  Texas

24. Signature of dependent  Maggie Mooring Rudd

25. Fingerprint of dependent

26. Item 26 for dependent only.

STATE OF  Texas

COUNTY OF  Bell

Subscribed and sworn to before me at
Temple, Bell Co., Texas   this  ___  day of __



_______  (Signature of individual administering oath)