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� [handwritten] I Eleazer Dickey on oath say and de-clare that I have no real nor personal Estate nor any income whatever, my necessary bedding and wearing apparel excepted except one fine c[?]
I am a Laborer but by reason of age and infirmity I am not able to labor but a little. My wife is aged [?] infirm
I have five children under age Hallet aged 17 years Patty aged 15 Hambleton 13 Jane 11 Alexander 9
I am not able to support myself and family without my pension.
Eleazer Dickey[signature]