May 13, 1863,
The Item gives the following as the correct form for an application to obtain Penitentiary goods:
The State of
Before me the undersigned authority, this day personally came Mrs. ________ of the same county, who made oath that the goods sought to be bought of the Texas Penitentiary, are for immediate use in her own family, consisting of _____ whites and ________ blacks, excluding male members in the army; and are not for barter, sale, exchange or speculation; and that she is the wife of a soldier in the Confederate States’ army, and that this is her [first or second] application.
I ________ Chief Justice of ________ county, certify that the above application was subscribed and sworn to before me, and that the facts set forth in the same are true [being verified by the oath of one credible witness.] In testimony of which witness [L. S.] my hand and seal of the County Court, the ____ day of ________ 1863.
____________________ Chief Justice.