Transcription of Forms No. 4 and No. 5 that were given to
soldiers upon their
discharge from the Confederate Army. This particular transcript is for Marion T.
Kilzer, son of Elijah Kilzer. Elijah Kilzer was my great-great grandfather.
Submitted by Bobby J. Williams
Form No. 4
Certificate to be given a Soldier at the time of his Discharge
I certify that the within-named M. T. Kilzer a private of Captain A. W. Campbell
Company K of the Twelfth Regiment of Tennessee Volunteers born in Smith County in the
State of Tennessee aged 25 years, five feet 10 inches high, light complexion, gray
eyes, light hair, and by profession a farmer, was enlisted by Captain A. W. Campbell
at Jackson, Tenn. on the 23rd day of May, eighteen hundred and sixty one , to serve
for one year......, and is now entitled to a discharge by reason of Disability .
The said M. T. Kilzer was last paid by Paymaster J. L Lea to include the 31st day of
December , eighteen hundred and sixty one , and his pay due from that time to the
present date. There is due to him ______________ dollars retained pay. There is due
to him ______________ dollars on account of clothing not drawn in kind.
He is indebted to the Confederate States Eight dollars on account of extra clothing
He is indebted to ,_______ laundress at dollars.
The contract price of the ration at his post is thirty cents.
Given in duplicate at Corinth, Miss. , this 20th , day of April , 1862.
H. H. George, 1st Lieut.
Form No. 5
The Confederate States To M. T. Kilzer , discharged from A. W. Campbell’s Company,
Twelfth Regiment of Tennessee Volunteers .
For pay from 31st of December 1861, to 20th Dollars Cents. of April , 1862, being
three months, twenty days, at eleven dollars per month $40.35
For retained pay due _______.
For pay for traveling from Corinth, Miss. , the place of my discharge to Humboldt,
Tenn , the place of my residence, eighty miles at twenty miles per day, equal to four
days, at eleven dollars per month. $1.45
For subsistence for traveling as above, four days, at thirty cents per ration or day, $1.20
For clothing not drawn Amount $43.00
Deduct for Army Asylum $______
Deduct for clothing overdrawn $8.00
Balance due $35.00
Received of J. L. Lea Paymaster C. S. Army, this 20th day of April , 1862, Thirty five dollars and cents, in full of the above account.