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'/'lee 1ln~to~ltvrLl~~ tl~~ .T~[~7~~s ~f tibe d'o~n•l 06' I'o~~a~at~~a Tlcu~ of Ctyj~pLe~•lrr~ttl A'oi~~ali/;
IIolding said Court at C:u•lislc, the l%'., ~~ clay of ~_ _ ~ 1S.~/f
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TIIE PETITION OF `~:i ,~•,~ ~:.~/,~,,~, ,~ ,•
Pespectfully represents,
That he has been arrested in execution and given bond conditioned for Lis appearance to take the benc(it of the
Insolvent Laws of this Commonwealth, agreeably to the provisions of the Acts oC Assembly in such cast made
and provided ; that he has resided within this State for six months and more, immediately preceding this, his
application ; that he offers to deliver up to the use of his Creditors, all his property, real, personal, and mixed,
to which he is in any mannercutitled ; 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 his losses, and the means wherc••
by he became insolvent, are exhibited with, and annexed to, his Petition : IIc therefore prays to be allowed
the benefit of the several Acts of Assembly of the Commonwealth of Pennsylvania, made for the relief of In-
solvent Debtors.
Sc~icclt~le of I'etitio~~er's IDro~erty.
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,+S'~at'cme~tt of Pcti ti oncr's IiOS.4P_ S, ancd t1~e Means w,~ierel~~
he Lecame litso~vent,
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CUMRF.ItT,ANI~ COUN'T'Y, ~.
The aforesaid Pctitioocr being duly • - * ' according to ]aw, doth say, chat all the facts
contained in the foregoing Petition, Schedule, List, and Statement, arc true, to the best of his knowledge and
belief.
~1~~~ :••• rcnrl suLscriLecl Lefi~re nae `~f%[4~ ' .~•!}J~ f ~ ~~ `
the ~~' ~ "day of ; l~ . ,. , . l~,j ~ ,
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KNOW AI,I., N:EN B~ ~'riE~~ PR,E~E'~2'~, TII~1T I, ~ ~~t-~-
~'-'~~ /%- - the within named 1'rtitioucr, do hereby assign, transfer, set over, and
dclivei`Up Tinto ~ r ~~~<< ~l~ ~ ~~
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.~ ~f my creditors, in pursuance of the directions of the Act of Assembly, all my Estate, real, personal, and
mixed, rer•ersions and remainders, ~~ Itiich I, ~w have, possess, claim, or am in any respect entitled to, in any
place whatever, in trust, for '::~:~:~~.:~-•,~nd my other creditors. ,
I~ `VITh~SS wIiERFr9Y, I l~a~`~: l~crcunto set my hand and seal, this ~y ~ -• ~ ~,
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day of ~ ~ <• -- t"-- -- in the year of our Lord, one thousand eight hundred and ~<" y
SEJlLED .2ND DLLII'ERED I:Y 'l!!E .PRESENCE OF ! I~
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