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P>•inlyd bu rCvn R. f.3 Jan:ea ti aader•wnnd, Carlislr,.
The Honorable the Judes of the C°ourt of Lommun Plead of Cumberland Coun.•y, Uolding
said Court at Carlisle, the d _of ~-v..>!c.Fti j. 1~~/-~
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~~$ ' ~$~~~~4~ Q~4'~'rl ~~1*~ respeetfullyrepresentsr
That he has resided within this state for six months and more, immediately lu•eeedin~.tl~is his
application; that be offers to delivrr up to the use of his creditors, all his property, real, per-
sonal, and mixed, to which he is in any manner entitled; a schedule whereof, together with a
list of his creditors and the nature of their debts, as far as he can ascertain them, with a state-
ment of his losses and the means whereby lre became insolvent, are exhibited with and annex-
ed to this petition. He therefore prays to be allowed the benefit of the several acts of nssem-
bly of the Common2oealth of Pennsyivareiat made for the relief of Insolvent Debtors.
A Schedule of Petitioner's Property. ~,~ ~f~-;
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List of Peti~inrpr's _ -L7
Ct•e~~i±nrs, ~~~ith the mature and
AMOUNT ON' 7.'IiEIli, DEBTS.
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Statement of Petitioner's Losses, and the means
~PHEREBY HE S)N:CAZtiTIJ INSOLVENT.
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The foregoing Petitioner being duly ~.~-,~ according to law, doth say, that
X11 the facts contained in the foregoing Petition, Schedule, List, and Statement, are true, to
the best of his knowledge and belief.
;~:,~~,•,+'~- and subscribed
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day of e~,~:u-l~. 182'
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the .within named Petitioner, do hereby assign, transfer, set over and deliver up, unto
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• two of my creditors. in pursuance of the directions of the Act of Assembly, all my estate,
real, prrsonal, and mixed, reversions and remainders, which I now have, possess, claim,
or am in any respect entitled to, in any place whatever, iu trust, fur themselves and my
other creditors. In witness whereof, i have hereunto set my band and seal, this
~f~r- day of vT~lu ~~in the year of our Lard, 482,
Beaded and Delivered
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in the presence of sr:.tayy
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