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`T'l><e I~o~lorable the Judges off` tt~e you t of Common Pleas of
Cumberland county, holding said Court at Carlisl!~, the ~~ ~ `-' day of Gv~~-~- 183
Respectfully represents,
`t'hat he has been arrested in execution and given bond conditioned for his appearance to take the benefit of the
Insolvent Laws of this Commonwealth, agreeably to the provisions of the Acts of Assembly in such case made
and provided; that he has resided within this State for six months and more, immediately preceding this, his
application; that he oll'ers to deliver up to the use of his Creditors, all his property, real, personal, and mixed,
to which he is in any manner entitled; a Schedule whereof, together with a list of his creditors, and the nature
and amount of their debts, as far as he can ascertain them, with a statement of Ills LOSS°s, and the means whereby
he became insolvent, are exhibited +vith, and annexed lo, his Petition: he therefore prays to be allowed the bene-
fit of the several Acts of Assembly of the Common ,realth of Pennsylvania, made for~the relief of insolvent
debtors. ~ ~~ t ( ~ :: ~ L ~ `- ~ c. t~~ l
Schedule of Petitioner's ProPert~. ~~
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.~~ist of Pctitio«cr's Creditor, «rith the uaturc and amount of
his dcUts, to wit:
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Statement of Petitioner's losses, an~i t!><c means whereby he
became insolvent.
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Cumberl~.ncl Conn~;y, ss
The aforesaid Petitioner being duly t according to law, cloth say, that all the faeta
contained in the foregoing Petition, Sch Jule, List., and Statement, are true, to the best of his Iuiowledge and
belief. _
rtnrl sttbscriberl Gr;/nrc ate ' 6C~~(~' ~~~' ~"e,~~./-~
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~l~•~~~~ ~1c~ ~~~ ,~~~ ~~~~~~1~t~, That I,
the within nautccl Petitioner, do hereby assi;~n, lransfcr, set over, and
dclivct• up unto
~ of m;' creclitot•s, in pttt•suaner; of the directions of the Act of assembly, all my Lstate, real, personal, ana
~c<l, r{;vcrsions and 1'C]1lalndCl's, which I now have, possess, claim, or am in any respect entitled to, in any
cu wliate~•cr, iu truce, iiu tbemscl~•cs, <<nd my other creditors.
(rt I! ilr<c•ss udicrrnf, I hat~c hcrcunlo set my hand and seal, this clay of
in the year of our Lord, one thousand eight hundred anti thirty
,,f~~:1 unrl rlclit~,^)•crl i+t f.'te ~~re•sence of 1 ..,,,
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