Form - 'Claim for War Pension', World War I, 1917, 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
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