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The Honourable the Judges of the Court of Common Yleas of Cum-
da of 182
Berland county, holding said Court at Carlisle the y
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Respectfully represents, that he has resided withiu this State for six months and more, immedi-
ately preceding this, his application ; that t e which thel isl in aPy manner entitled ;i a schedule
his property, real, personal, and mixed,
whereof, together with a list of his creditors, and the nature of their debts, as far as be can as-
eertain them, with a statement of his losses, and the means whereby he• Uecame insolvent, are
exhibited with, and annexed to, his Petri ealth of Pennos 1 ania., ma a for th a rel of of inlsolvelnt
several Acts of 1lssemLly of the Common y
debtors,
Schedule of Petitioner's Property'- ~ ~ ,~~ ~~~ L ~
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List o~ Petitionet•'s Creditors, with the nature and amount of bis
~Pbts, to wit :
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Statement of Petitioner's losses, and the means whereby he became
insolvent.
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Cumberland County, ss.
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The aforesaid Petitioner being duly - according to law, loth say, that all
the facts contained in the foregoing Petition, Schedule, List, and Statement, are true, to the
best of his knowledge and belief.
- and subscribed before me, ,_. - ~~ G.~~ ~~. c
the ~c; day o f - ~ ! 3~ - } '' r~ ` ~ ~
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the within named Petitioner, do hereby assign, trausfer, set over, and deliver up unto
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twu of my creditors, in pursuance of tlic directions of the Act of Assembly, all my l~!:state, real,
personal, and mixed, reversions and remainders, tivhich I now have, possess, claim, or am iu
any respect entitled to, iu any place whatever, in trust, for themselves and may other creditors.
]n IVitness, icleereof, l have hereunto set my hand and seal, this
,.S ~" ~'l day of
x~ ~~~1: ~•- ~ --~~ ~,/ in the year of our Lord, one thousand eight hundred and twenty ,~. .- ~ ~ ~ ~
~S"ealed and Delei~ered in the presence of
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