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61 Roseberry Road, Brixton Hill, SW2
10.9.27
Dear Sir
I beg to acknowledge the receipt of your letter life see S3 for yesterday's date together with the receipt of the first payment made by me in respect of policy number 171 8814, and perform for me to complete forward to the Paymaster general to authorise him to deduct from my pension each quarter premium as it becomes due on the said policy in the future.
You will please observe that the policy P154793 and that which you are about to issue to me bears the name of David John Morris whereas my baptismal name was John and not David John stated.
I assumed the name of David when joining the army on 16 November 1892 because I did not want my parents to find out that I'd taken such a step dead of acting upon their advice to study law or medicine, and that has been my official name ever since.
There is no doubt to know this and my last will and testament will also make this clear.
Would you therefore kindly make a note of this in your records so that you may be all the better able to identify me, the insured person with the policies issued whenever the time for the payment of the claims arises.
I am dear Sir, yours truly signed DJ Morris
Life proposal North British and mercantile insurance company limited
Full name and residence of the person whose life proposed to be assured: David John Morris, married.
Date of your first appointment to an established situation in the civil service: 1 April 1897.
Department and position to which you are appointed: HM prisons assistant warder.
Whether in respect of the appointment you passed the usual examination of the civil service Commissioners: yes.
Whether you were medically examined for such situation on behalf the civil service Commissioners and the date of such medical examination: yes but have lost record of date
Present position and where employed in HM's HM civil service: Superannuated at own request on 1 8 27. I then held the rank of clerk and schoolmaster at Brixton Prison.
Whether the position entitles you to pension on retirement: yes.
From which department and which branch of it you receive your salary and what dates: I draw a pension instead at the Paymaster general's office Whitehall SW1
Where are you born and when at Cinderford in the County of Gloucester: 29 March 1872. Age next birthday: 56
State the ages of your brothers parents and sisters alive and the present condition of their health if any are dead state and what ages and what diseases they died: father - dead aged 71 and 11 months of cancer of the anus.
Mother - alive aged 80 and six months. fairly good health
Brother - aged 42 and one month. very good health
Sister - age 54 and one month. fairly good
Sister - alive aged 50 and 10 months. very good health
Sister - age 49 and 4 months (?). very good health
Sister - age 47 and 7 months. very good health
Sister - age 45 and 10 months. fairly good health
Sister - aged 38 and 8 months. very good health
Brother - died aged 1 year and 6 months of scarlatina
brother - died aged 1 year and 5 months of convulsions
Are you strictly sober intemperate habits yes
have you always been so yes
When was your usual medical attendant last impression attendance of the nature of the element May 1917 concussion of the brain bracket thrown off a bicycle bracket consulted any other medical persons: yes late Dr Paul the North of Cinderford and Dr Lane late medical Sir of Hereford prison.
What occasions of what diseases have you consulted them: scarlet fever 126 years of age and colic about 24 years of age
have you ever resided beyond the limits of Europe and if so where when and how long: yes in Jamaica the WRI. Of February 1894 to 28th of November 1895. I also spent two days and nights in New York December 1895.
Have you present any intention of proceeding beyond the limits of Europe: I might travel to Australia some other part of the British Empire but not to permanently reside outside Europe |
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