Grey form printed in black, of several pages. To be completed by a dependent (including a wife or widow) over the age of 16 who had been bereaved by war. It has been stamped 'Melbourne'. The form requests details of the 'member of the Forces on whose death or incapacity the claim is based', the dependant's relationship to that person, and the level of financial dependency on that person. The form ends with two pages of information 'For Registrars, Special Magistrates, and Claimants, covering 'Persons Entitled, and Rates Payable', 'How and When to Apply for Pension', 'Payment of Pensions' and 'How Long Pensions are Payable'. Widows lost their pensions two years after re-marriage. The form was issued under the War Pensions Act 1914-1916.

The form relates to attempts by Annie Kemp, widow of Pte Albert Edward Kemp (killed in action in 1917, during World War I) to obtain a widow's pension. It has not been filled in. Annie did receive a war pension but appears to have fallen on hard times, struggling to pay rent and bills and support two children - suggested by her need for assistance with a grocery bill . She worked as a seamstress to support her family, but was eventually evicted from her home (later she managed to purchase a home, perhaps with family assistance). She never re-married.

Physical Description

Grey form printed in black, comprising four double sheets, stapled together and folded to create eight pages. The form has not been filled in.

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