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New York Asylum For Idiots, Twelfth Annual Report

Creator: n/a
Date: 1863
Publisher: Comstock & Cassidy, Albany
Source: Steve Taylor Collection

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# 21. The provisions of section nineteen of this act shall be applicable to all State pupils now in the Asylum. And any bond, bill, note, agreement, undertaking or other security for the maintenance or support of any pupil at the Asylum, heretofore made by any person in his behalf, and now belonging to the Asylum, shall be valid and effectual in law, and may be prosecuted as provided in section fifteen of this act.

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# 22. All laws and parts of laws inconsistent with the provisions of this act, are hereby repealed.

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# 23. This act shall take effect immediately.

(I.) FORM OF REQUEST FOR ADMISSION OF PUPIL.
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To Henry B. Wilbur, Esq., Superintendent of the State asylum for Idiots, at Syracuse, New York:

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I hereby request that A. B. (giving the name of the proposed pupil in full, and stating the degree of relationship, or other circumstance of connection, if any, with the applicant, thus: "my son," or "lately in my employ," or "a member of my family, but not related," or otherwise, as the case may be), who is an idiot, and resides in the _____ of _____, in the county of _____, in the State of _____, may be admitted as a pupil into said Asylum.

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The said A. B. was born in the _____ of _____, in the county of _____,in the State of _____, and is of about the age of ___ years.

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Said idiot * is of sufficient ability to provide wholly for (his, her) support at the Asylum.

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Dated the _____ day of _____,186__. (Signed) C. D., of the town of ______, county of _____, and State of _____.

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STATE OF NEW YORK, COUNTY OF _____, ss.

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E. F. and G. H. being severally duly sworn, say, and each for himself says, that he is a resident of the county of _____,(the county where the idiot resides,) in the State of _____, that he is acquainted with the facts and circumstances stated and set forth in the foregoing request signed by C. D., and that the same are true. (Signed) E. F.
G. H.

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The foregoing affidavit was on the _____ day of _____, 186___, subscribed and sworn to before me by the above named E. F. and G. H., known to me to be credible persons; and I certify that (name of idiot) the idiot in the preceding request named is an eligible and proper candidate for admission as a pupil into the State Asylum for Idiots.

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(Signed) I. K., County Judge of said county.

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N.B. If the idiot is not of sufficient ability to provide out of his own means for his entire support at the asylum, then insert, after the * in lieu of the statement in the foregoing request, such one of the following as may be according to the facts of the case, viz:

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"Is not of sufficient ability to provide wholly for (his, her) support at the Asylum, but can pay towards the same the annual sum of _____ dollars." (Specify the sum.)

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Or, "has no parent or guardian, and is not of sufficient ability to provide in any part for (his, her) support in the Asylum."

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Or, "has a (father, mother or guardian, as the case may be,) who is not of sufficient ability to provide wholly for (his, her) support at the Asylum."

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Or, "has a (father, mother or guardian, as the case may be,) who is not of sufficient ability to provide wholly for (his, her) support at the Asylum, but can pay towards the same the annual sum of _____ dollars." (Specify it.)

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Or, "has a (father, mother or guardian, as the case may be,) who is not of sufficient ability to provide in any part for (his, her) support at the Asylum."

(II.) FORM OF BOND FOR SUPPORT AND REMOVAL OF PUPIL.
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Know all men by these presents, that we C. D., of &c., E. F., of &c., and G. H., of &c., (giving their names and places of residence in full,) are held and firmly bound unto Hamilton White, Treasurer of the State Asylum for Idiots, in the sum of (at least double the annual payment) ______ dollars; to be paid to the said Hamilton White, as treasurer aforesaid, his successors in office, or his or their assigns; for which payment, well and truly to be made, we bind ourselves and our and each of our heirs, executors and administrators, jointly and severally, firmly by these presents. Sealed with our seals, and dated the _____ day of _____ 186___.

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Whereas, C. D. has made request in writing, to the Superintendent of the State Idiot Asylum, that A. B., an idiot, be received as a pupil into said Asylum.

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Now, therefore, the condition of this obligation is such, that if the above bounden C.D. shall and do -well and truly pay or cause to be paid to the above named Hamilton White, as treasurer aforesaid, or to his successors in office, the annual sum of _____ dollars and _____ cents, in (quarter or half) yearly installments as follows, to wit, the sum of _____ dollars and _____ cents, on &c., (according to the agreement), so long as the said A. B. shall continue to be a pupil at said Asylum, and until (he, she) shall be discharged and removed therefrom, and shall- within twenty days after the service of the notice prescribed by section 20, chapter 220, of the Laws of 1862, in the manner in said section provided, remove the said A. B. from said Asylum, free of expense to the trustees thereof, without fraud or delay, then this obligation to be void, otherwise to remain in full force and virtue.

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