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� [the following is a pre-printed form with handwritten inserts, deletions, additions, and testimony]

STATE OF MAINE [header]

COUNTY OF PENOBSCOT, ss.

At a Circuit Court of Common Pleas begun and holden at Bangor within and for said County on the twentyseventh of June A.D. 1820[handwritten]

ON this 27th[handwritten] day of June[handwritten] in the year of our Lord eighteen hundred and twenty, personally appeared in open court, being a Court of record within and for said County and State of Maine, having the right of fine and imprisonment[handwritten] established by law of the Commonwealth of Massachusetts, made and passed on the eleventh[stricken] twentyfirst[handwritten] day of June A.D. 1811, and recognized by the Constitution of the State of Maine John Bolton[handwritten] aged sixty seven[handwritten] years, resident in Brewer[handwritten] in said County of Penobscot, who being first duly sworn according to law, doth, on his oath, declare that he served in the Revolutionary war as follows: [handwritten] Viz.