No. ——.

  BOOTH IN T. ——­ N., R. ——­, ——­, 1893.

I, ——­, of ——­, being desirous of occupying or entering upon the lands opened to settlement by the President’s proclamation of August 19, 1893, for the purpose of making a homestead entry, do solemnly declare that I am over 21 years of age or the head of a family; that I am a citizen of the United States (or have declared my intention to become such); that I have not perfected a homestead entry for 160 acres of land under any law except what is known as the commuted provision of the homestead law contained in section 2301, Revised Statutes, nor have I made or commuted a homestead entry since March 2, 1889;[*] ——­ that I have not entered since August 30, 1890, under the land laws of the United States or filed upon a quantity of land agricultural in character and not mineral which with the tracts now desired would make more than 320 acres; that I am not the owner in fee simple of 160 acres of land in any State or Territory; that I have not entered upon or occupied, nor will I enter upon or occupy, the lands to be opened to settlement by the President’s proclamation of August 19, 1893, in violation of the requirements of said proclamation; that I desire to make entry for the purpose of actual settlement and cultivation, and not for the benefit of any other person, persons, or corporation; that I will faithfully and honestly endeavor to comply with all the requirements of law as to settlement, residence, and cultivation necessary to acquire title to the land I may select; that I am not acting as agent of any person, corporation, or syndicate in entering upon said lands, nor in collusion with any person, corporation, or syndicate to give them the benefit of the land I may enter, or any part thereof, or the timber thereon; that I do not apply to enter upon said lands for the purpose of speculation, but in good faith to obtain a home for myself; and that I have not, directly or indirectly, made and will not make any agreement or contract in any way or manner with any person or persons, corporation, or syndicate whatsoever by which the title which I may acquire from the Government of the United States should inure in whole or in part to the benefit of any person except myself.

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  I certify that the foregoing declaration was made and subscribed before
  me this ——­ day of ——­, 1893.

-------- ----------, Officer in Charge.

* NOTE.—­If the party has made a homestead entry since March 2, 1889, but has failed or is unable to perfect title to the land covered thereby because of a valid adverse claim or other invalidity existing at the date of its inception, strike out the words “made or” and insert in the blank space that I have made a homestead entry since March 2, 1889, but have failed or am unable to perfect title to the land covered thereby because of a valid adverse claim or other invalidity existing at the date of its inception.

B.