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F'~ >~ir~:~ amt•fv;• ;'r~[e, .at the o~Jice of t1.:.9:;urcc _~.~ _ ----.~- _ -`-
~~ 'ral~lc the Jucl~res of• tl~e Court of (~c~innion Pleas of Curli-
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berland county, holding said Court at Carlisle, the ~ ~ "`` `~'~`~' "t ~ ` `'"~ i~N
]respectfully represents, that he has resided within tulil lir•ei uo~ to Llie useJufihis ~~reditors,t all
ately preceding this, his application , that he uil'e~rs L
his property, real, I~ersonal, aucl mixed, to whicltllh --ature fttiieiralcbts, atstfar asahc eanlas~-
whc;rcof, together with a list of his cred~turs, and
certain them, with a statement of l-is'losses, l~hc thereforrnsr`n!s tot,b lall~ wed the l e ~elit,of thc~
exhibited witL, and annexed lo, lii5 1 etation . l
several Acts of Assembly of tlic l;ou-nlonwealth of I'enn~•1~:~~~!;~~ 5'-i«~!`. ~• ~~ ~'::«; ~~~•1it~i'nt !us~~l~•czi!
debtors. ~ ~ ~ . • •
Sel-cd«lc of• ~'ctitioner h •r:;l;~- ~ :-°
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List of Petitioner's Cc•editors, with the nature and amount of his
debts, to wit
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Statement ot- Petitioner's losses, and the means
whereby he became
jnsolvent.
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Ct~mber]atld Cot~i~tt-, ss.
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The aforesaid Petitioner being duly -,~~,~, ~
the facts contained in the forc~*oin~• ]~ according to ]aw, cloth say, drat all
best of Lis knowledge and belie(: ~ ctrtron, Schedule, List
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tlae / ~, tzi dn~ of ~r'2-L
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the within named Petitioner, do Lereby assign,
Ind ~~tatemcnt, Ire true, to th~~
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That I, , ~ , ,~,
transfer, set over, and deliver up unto
!nw of m3• creditors, in pursuance of the directions of the Act of Assembly, all m If,state
Y ,real,
personal, and mixed, reversions and remainders, which I uow have, possess, claim or am
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any respect entitled to, in any place -vhatever, iu trust, for themselves and my other creditors.
1n h1'itness whereof, I Dave hereunto set my 6anr1 and seal, this
~~ ~ in the year of our hoed, one thousand eight hundred and tweet clay of
Sealed and Delivered in tlce y '`~'~`--
p
esence of
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