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Printed L4 TYm B. f1 Jomeu rreder+nnnd, Cnrlisle.. _
The gonorable the 5udges of the Court of l;ommon Yleas of Cum.berlaad CouBty, la iSQ
day of ;` ~
said Court at Carlisle, the ^~,
respectfully represents,
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That he has th~?~ ~ ~e a tohdeli~ etr up tolthe usehof l s emreditors all hislpr petty. heal lepers
application ,
sonal, and mixed, to which he is in any manner entitled; a schedule whereuf, together with a
list of his creditors and the nature of their debts, as far as he can aseertaiu them, with a state-
ment of his losses and the means whereby he became insolvent, are exhibited with and anuex-
ed to this petition. He therefore prays to be allowed the benefit of the several acts of Assem-
lrly of the Commonwealth of yennsylvaroia! made for the relief of Insolvent Debtors.
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_. if ~. Schedule of Petitioner's Prope-~ty._
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T.ist of PetitionPr'c Cre{Iitors, with the nature and
t~1V10LTNT OI+' THEIli, DEBTS.
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Statement of Petitioner's Losses, and the means
W1iEREBY HL+' 13L+'CAME INSOLVENT.
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all the facts contained in the foregoing Petition, Schedule, List, and Statement, are tree, to
the beet of hia knowledge and belief
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before me, the /'~ l / jl 1 * ~I °
day of , ~; _ _ ~ ~_ 18~ j I
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the within named Petitioner, do hereby assign, transfer, set over and deliver up, unto
e,~~,f.,.~~Tuf my red', of rs. in pursaance of the riireetions of the Act of Assembly, all my estate,
real, personal, and mixed. reversions and remainders, which )<. now have, osge~s claim,
or am in any respect entitled to, iu any place whatever, in trust, for ~•s~and my
other creditors. In witness whereof I have hereunto set my hand and seal,'Ihiw %2 ~
day of ~ic~-~h~- :" the year of our Lord, 482J
Sealed and Deltivered ~ ~i y~y
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