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STATE OF MAINE. Hancock ss.... At a Circuit Court of Common Pleas for the third Eastern Circuit, begun and holden at Castine within and for the County of Hancock on the second tuesday of July being the eleventh day of said Month and by adjournment from day to day, on the fourteenth day of said month in the year of our Lord one thousand eight hundred and twenty, before the Honorable William Crosby and Jas Campbell Judge of said Court.

ON this fourteenth day of July in the year 1820, personally appeared in open Court the same proceeding according to the course of the common law, having jurisdiction unlimited in amount, keeping a record of their proceedings, and having "the power of fine and imprisonment," and being a Court of Record for said Circuit, Perley Haynes in said Circuit, who being first duly sworn according to law, doth on his oath declare that he served in the Revolutionary War as follows, viz. as a Drummer in the company commanded by Capt. Blanchard in the Regiment commanded by Colonel Wesson in the line of the State of Massachusetts on the Continental Establishment, as is more particularly mentioned and described in his original declaration, made on the Seventh day of May A.D. 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. Perley Haynes Sworn to and declared, on the 14th day of July A.D. 1820 BEFORE William Crosby Sign James Campbell Judges of the said Court

Attest Mason Shaw [?]