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TIIF PIJTITIO~ OI` <~~ --• -• ~ ~'~_~~~ .-,--
Pcspectfully represents, ~ r _ /
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'I'hat he has been arrested iu.crrtulie+i and given ~~b~~ond ~onc~l}•t~ioi~cl fpr leis appearance~to talseJth~ bcy~;~,LF the
Insolvent Laws of this Commonwealth, agrceably'to the provisions of the Actj of As§embly in sdch case made
and provided ; that he has resided within this State for six months and mm•c, immediately preceding this, his
BpphCatl011 ; that he otters 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 lint 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 where-
by he became insolvent, arc exhibited with, and annexed to, his Petition : IIc therefore prays to be allowed
the benefit of the several Acts of Assembly o£ the Cwnmonwealth of Pennsylvania, made for the relict of In-
solvent Debtors.
Scl~edtile , of Petitiotiei~'s Praperty~e / ~ ~ ~ • L~
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S~u~caaient o~ f' PcCit,'-io~icr's Losses, and flee 1lTeu~t~~ zv,lcere~y~
,~~ ~~ become l~asolvent`.
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CUMI3ERLANn COUN'['Y, ss.
The aforesaid Petitioner being duly c~ ~~ ~• .• • ~ according to law, ~1otih say, that all the facts
contained in the foregoing Petition, Schedule, List, and Statement, are true, to the hest of his ltnowledge and
belief.
'-~f`" ` ' " rind su scribed Le nre ~iac / ` -~
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KNEW AyL MBN BY `~~3E~B PRB~B~'~~, TII~1T 1, ~ ~»«ur ,~~r,''
the tvilhin named Petitioner, do hereby assign, transtet•. srt over, any!
deliver up unto v ~i ~ 6~- ~ ~~ ~~~ : ~; ~,. ~.
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ht~ of my creditors, in pursuance of the directions of the Act of Assembly, all my Lstatc, real, personal, and
miscd, reversions and remaiudcrs, which l nosy have, possess, claim, or am in any respect entitled to, iu any
place whatever, in trust, for themselves, and my other creditors.
IN WI1•NE$9 wuEi;EOr, I have hereunto set my hand and seal, this ~ ~ _ -~--
day of (~,!c~ Gtr t •--- in the year of our Lord, otlc thousand ci~ftt h~uulrcd and ~~~ "~< < ~ L
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