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[copied on top of document that is following page, so see following page for those pieces]
I Nicholas Coffin on oath say + declare that I have no real estate except a quit claim Due to a will lot of land in Belfast appraised of about 57 acres - upon which I have encumbered an improvement and where I had built a house which was burnt by accident last spring -- with all my effects -- But I have no[inserted] confidence in my title.
I have no personal estate except my wearing apparel which I have on, the principal part of my clothing was burnt in my house, nor any income whatever, except [?] a [?] chest [?] [?] set out worth about $25 --
I have but two children under age -- Walter ten years old Nicholas in his fifth year
I am a farmer and enjoy tolerable health but under my misfortunes am unable to support myself without the aid of public or private charity Nicholas Coffin