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[typed form with handwritten insertions where noted] STATE OF MAINE. Hancock[handwritten] ss....At a Circuit Court of Common Pleas for the third[handwritten] Eastern Circuit, begun and holden at Castine[handwritten] within and for the County of Hancock[handwritten] on the third Tuesday[handwritten] being the twenty first[handwritten] day of November[handwritten] and by adjournment from day to day[stricken] on the 22[handwritten] day of November[handwritten] in the year of our Lord one thousand eight hundred and twenty, before the Honorable William Crosby & James Campbell[handwritten] Judges of said Court. ON this twenty second[handwritten] day of November[handwritten] in the year 1820, personally appeared in open Court[handwritten] 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, Michael Larry[handwritten] aged sixty six[handwritten] years, resident in Castine[handwritten] in said Circuit, who being first duly sworn according to law, doth on his oath declare that he served in the Revolu-tionary War as follows, viz, as a Private[handwritten] in the company commanded by Capt.s Popham + Sullivan[handwritten] in the Regiment commanded by Colonel Moyland[handwritten] in the line of the State of Pennsylvania[handwritten] on the Continental Establishment, as is more particularly mentioned and described in his original declaration, made on the ninth[handwritten] day of May[handwritten] A.D. 1818[handwritten], and on which said declaration his Certificate of Pension, numbered 17.257[handwritten] was granted. 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 : ans that I have not, or 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 con-tained in the schedule hereto annexed, and by me subscribed ; that my occupation and ability to pursue the same , together with the number and particulars of my family, are in fact and in truth as is par-ticularly described on the back hereof, also subscribed by me. his Michael x[mark] Larry mark Sworn to and declared on the 22 day of November A.D. 1820 Before William Crosby + James Campbell Judges of said Court attn. Mason Shaw Clerk

SCHEDULE of the real and personal estate , (necessary clothing and bedding ex-cepted) belonging to me the subscriber, viz : [handwritten insertions follow]Real Estate none one chest of the value of two dollars 2.00 one ax 6/ Jack Knife [1/11?] Tobacco [1/11?] 1.50 annual Income by Labour 12$ his Michael x[mark] Larry mark

SCHEDULE of the family residing with me Michael Larry[handwritten] who, by occupation am a labourer[handwritten] which I am unable to pursue by reasons of [handwritten]an injury I received in my back several years since- the asthma and general debility NAMES. AGES. Capacity of each to contribute to their support. I have no family living with me at present his Michael Larry mark