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Prirrfed by bP>n B. v .lnmea 9Jvdu~zr,nnrl• Carlixlr. ~~
~'Le honorable the nudges of the Court of l:ommon Pleas of Cum6erla;id Caun:y, holding
said Court at Cav~liale, the ..^* -~ ~ ~`'~~ day of ~~. ~ r ~_ ~ ~lz, ' ill
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%' respectfully represents
That Le has resided within this state for six months and more, immediately precedin„ this his
application; that he offers to delir•er 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 Lis 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 he became insolvent, are exhibited with and annex-
ed to this petition. ~1e therefore prays to be allowed the benrfit of the several act of nssem.
bly of the Commonwealth of Pennsylvania, made for the relief of Insolvent Debtors.
A Schedule of Petitioner's Property.
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Statement of Petitioner's Losses, and the .:cans
W13EIi,EBY HE BEOAME INSOLVENT.
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The foregoing Petitioner being duly C ' °'' ~"` -- according to law, Moth say, that
all the facts contained in the foregoing Petition, Schedule, List, and Statement, arQ true, to`
the best of his knowledge and belief.
and subscribed xJ1'~'~
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before me, tho ~ ° a ' ' I
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the within named Petitioner, do hereby assign, transfer, set over and deliver up, unto
two of my creditors, in pursuance of the directions of the Act of Assembly, all my estate,
real, personal, and mixed, reversions and remainders, which I now have, possess, claim,
,. or am in any respect entitled to, in any place whatever, in trust, for themselves and my
other creditors. In witness whereof, I have hereunto set my hand and seals this
day of in the year of our Lord, 182
Sealed and Delivered
in the presence of
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