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� [the following is a pre-printed form with handwritten insertions noted0 STATE OF MAINE

Hancock [handwritten] ss At a Circuit Court of Common Pleas begun and holden at Castine [handwritten] within and for the County of Hancock [handwritten] on the 2nd Tues [handwritten] day of July [handwritten] A.D. 1820

On this thirteenth [handwritten] day of July [handwritten] 1820, being the Third [handwritten] day of said term, personally appeared in open court, being a court of redord, by the laws of said state, with power of fine and imprisonment Wm Carr [handwritten] aged 64 [handwritten] years, resident in Frankfort [handwritten] in said county, who being first duly sworn according to law doth on his oath declare that he served in the revolutionary war as follows, to wit: [handwritten] as a private Q[?] the [?] from Febr 1777 in Cap'n Wm Burnhams Com in Col'l Michael Jacksons Regiment in the Massachusetts Line

[form] of all which I made declaration before the Honorable Judge Crosby [handwritten] on the 1st [handwritten] day of April [handwritten] 1818, and have received my pension certificate therefore, No. 9069 [handwritten]

and I 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.

William Carr [signature]

Sworn to and declared on the thirteenth[handwritten] day of July[handwritten] A.D. 1820 before the Court [handwritten]

attest Mason Shaw Clerk