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� State of Maine

At a circuit court of Common Pleas begun and holden at Castine within and for the county of Hancock on the second Tuesday of July 1820

On the 11th day of July personally appeared in open court being a court of record by the Court by the laws of said State with laws of fine and imprisonment [inserted - and usually "the right of..."] Thomas Burkman aged 76 years resident in Northport in said county who being first sworn according to law doth on his oath declare that he served the revolutionary war as follows, to wit, as a Ca[?] and Le[?] from Jan 1777 till after June 1779 in Capt Nathan'l Crafts [?] of horse in Col'l Elisha Sheldon's 2nd Regiment of light Dragoons Massachusetts Troops whereof I made declaration Before The Hon Wm Crosby one of the Judges of said court on the thirty first day of March 1818 and have rec'd my Pension certificate therefore No 9268 and

[pre-printed form with handwritten insertions and deletions]

I Thomas Burkham [stricken] aforesaid[stricken] do solemnly swear that I was a resident citizen of the United States on the 18th day of March 1818; and that I have not since that time by gift, sale, or in any manner disposed of my property, or any part thereof, with intent thereby so to diminish it as to bring myself within the provisions of an Act of Congress, entitled "An Act to provide for certain persons engaged in the land and naval service of the United States, in the Revolutionary War," passed on the 18th day of March, 1818; and that I have not, nor has any person in trust for me, any property or securities, contracts, or debts due to me; nor have I any income other than what is contained in the schedule hereto annexed, and by me subscribed; that my occupation and ability to pursue the same, together with the number and other particulars of my family, are in fact and in truth as is particularly described on the back hereof, also subscribed by me.

Thos Burkman

[numbers written on facing sideways:] 18 5 ____ 23

1820[stricken] [stricken] [stricken]

Sworn to and declared on the 11th day of July 1820 Before the Court

att Mason Shaw Clerk