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� [the following is a pre-printed form with hand written insertions, deletions, testimony and schedules]
STATE OF MAINE
COUNTY OF PENOBSCOT, ss. At [handwritten] Circuit Court of Common Pleas begun and holden in Bangor within and before said county on the fourth Tuesday of June A.D. 1820. [handwritten]
On this 27 [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 the State of Maine, established by a 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, and having power of fine and imprisonment [handwritten]
Ezekiel Chase [handwritten] aged fifty nine [handwritten] years, resident in Sebec [handwritten] in said county of Penobscot, who first being duly sworn according to law, doth, on his oath declare that he served in the Revolutionary War as follows: