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Ministry of Pensions
Date of Issue of Form: 14.2.45†
Office Address: Ministry of Pensions
††††††††††††††††††††††† Tyrone House
Application for Pension Ė Parents of deceased members of the Forces
I. Particulars relating to deceased member of the Forces
1. Name in full (Surname first in BLOCK letters): (1)
2. (a) Ship or Unit: (1)
3. (This question to be answered only if death occurred after termination of service)
(a) Date of Death . . . . . . .†† (b) Place of Death
4. Was they (here the word he is preceded by t and followed by y) single, married, widower, divorced or separated? Single.
5. Did they leave any other dependants?
If so, state their names and addresses and their relationship to him. No
N.A.B. Wt.T.773 15m 5/44 A.W.D & Co. Ltd.
6. Did your sons contribute to your support before the present war, or the commencement of his service with the Forces, if later? Yes, but see below (8)
If so: (a) What was the amount of his (their) regular contribution?
(b) How long had they been contributing at this rate?
(c) If you have any written evidence in support of your answers to (a) and (b) you should enclose it.
(d) Name and address of his (their) employer: (1) Mackies
(e) What benefit did your son receive in return for his contribution, e.g. board and lodging, clothing, etc? Everything possible.
7. Did your sons contribute to your support during his (their) war service?† Yes.
If so: (a) What was the amount of his (their) regular contribution? 7/= each weekly
(b) What amount did you receive :-
(i) As allotment? 7/= weekly† (ii) As dependantís allowance?
(iii) As a War Service Grant? (State number of Allawance Form Book)
(iv) In any other form such as direct remittance? (Evidence of this should be forwarded if possible) Sent direct remittances. £2 to £3 every 6 weeks. Sent by P.O. Letters until George was killed, occasionally by David.
8. I your son made no contribution before the war, was he an apprentice or studying for a profession?
I so, give particulars and date on which his apprenticeship or studies would have been completed. Both sons were apprentices and gave us all their wages out of which ? them gave their pocket money.
II. Particulars relating to applicant
9. Your name in full (Surname first in BLOCK letters) DOUGLAS Elizabeth Ann
10. Your relationship to the deceased Members of the Forces in respect of whom you claim pension. Mother
Your home address in full: 18
12. (a) Are you married, widowed, divorced or separated? Married
(b) Date of your first marriage: 10.8.1918
(c) If you have re-married, state date of re-marriage.
(d) If you are a widow, state date of husbandís death.
13. Give particulars of every any pension, allowance, gratuity, etc., that has at any time been awarded or granted to or in respect of the deceased member or yourself, or your husband/wife or any of your children (including step-children and adopted children), whether now in payment or not. I none put ďNONEĒ NONE
15 Do you claim to be in pecuniary need arising from old age or from infirmity or any other adverse condition not being merely of a temporary character? Infirmity
If so, state the grounds of your claim (See note A)
III. Particulars to be supplied where Certificates are not available.
(In this Part give full names, the surname first in BLOCK letters. For places give full address if possible.)
16. If you cannot readily supply a certificate of your sonís birth, state:-
Date of his birth (1) 8.12.21 (2)
26.9.24† (b) Place of Birth (
(c) His fatherís name: Robert James Douglas
(d) His motherís name: Elizabeth Ann Douglas
(e) His motherís maiden name: McDowell
DO NOT WRITE HERE
17. If you cannot readily supply a certificate of your marriage, state :-
(a) Date of marriage: 10.8.1918
(b) Place of marriage St. Anneís
(c) Wifeís surname before marriage Mc Dowell
18. If you cannot readily supply your own birth certificate or that of your husband or wife, state :-
(a) Date of Birth 6.11.98† (b) Place of birth
(c) Your fatherís name George McDowell
(d) Your motherís name Margaret McDowell
(e) Motherís maiden name Kelemate
Your Husband or Wife:-
(a) Date of birth 11.6.97† (b) Place of birth Lachin,
(c) Fatherís name James Douglas
(d) Motherís name Jane Douglas
(e) Motherís maiden name McKeown
The remainder should be readily apparent