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Life Insurance policy bought by Robert James McFarland

bitmap image of first page (on CD only)
bitmap image of second page (on CD only)

APPLICATION FOR MEMBERSHIP AND BENEFITS IN THE
MODERN WOODMEN OF AMERICA
A Fraternal Beneficiary Society Incorporated, Organized, and doing business under the laws of Illinois

Trempeleau, State of Wisconsin, Feby 17th 1889
To the Head Camp Modern Woodmen of America, and to the Members of Liberty P...
Camp, No. 2813, located at Trempeleau, County of Trempeleau, State of ...

I hereby make application for membership in your camp and the Society of the MODERN WOODMEN OF AMERICA, and [ask]
indemnity in case of my death while a member in good standing in said Society in the sum of one thousand dollars ($1000)
and for such purpose I hereby tender to said Society the following true and complete answers.

The following captures the genealogical claims in this policy, located by Alberta horan (a neice),
but a scan of the text may be seen (on CD only). Underlined words were hand-written :
Robert's account of dates and ages cannot be trusted ; e.g., Robert probably filled this out in 1899 (not 1889).
and we have Irish birth registrations for his 4 sisters, giving their birth dates as [Matilda] October 1964, [Charlotte] May 1867, [Caroline] October 1868, and [Juliana] February 1874. These birth dates correspond exactly (within 2 days) of what Charlotte wrote in her bible.

  • I was born in Ireland on the 24 day of December, 1879, and am now
    19 and 20 years of age. Are you married? No
    Charlotte's bible and letter from Balygawley give Robert's birthdate as 24th Dec 1878.
  • What is your occupation? Laborer. Place of business Trempaleau
  • [omissions
  • I direct that the benefit Certificate which may be issued to me in pursuance of this application recite as beneficiries ..
    $500 to Fred McFarland Trempaleau State of Wisconsin , brother
    $500 to Thomas A. McFarland Trempaleau State of Wisconsin , brother
  • Witness F.S. Metcaff
relationship Age if living age at death cause of death How long ill &
date of death
father   64 Inflammation
brain
7 years
1893
mother   54 Injury
to back
4 Months
1891
brothers 4 24      
26      
  4 yrs Chorea  
  3 mos inflammation
stomach
 
sisters 6 20      
26      
25      
22      
Father's father   98 don't know don't know
Father's mother   89 don't know don't know
Mother's father   68 don't know don't know
Mother's mother   99 don't know don't know