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� [the following is a pre-printed form with handwritten insertions, deletions, oaths and schedules]

STATE OF MAINE COUNTY OF PENOBSCOT, ss Circuit Court of Common Pleas begun + holden at Bangor in + for said County on the third Monday of Sept A.D. 1820 [handwritten]

On this 20th [handwritten] day of September [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] 21st [inserted] day of June, A.D. 1811, and recognized by the Constitution of the State of Maine, William Davis [handwritten] aged fifty seven [handwritten] years, resident in Eddington [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] that in the year 1781 he enlisted into the United States service as a private soldier, in the month of January he joined the ninth Mass Regt at West Point, in the State of New york commanded by Col. Jackson in Capt. Walkers Company I served in this [Company - stricken] Regiment until it was disbanded in 1782 and being a 3 years man was transported into the 2nd Regt Mass'tts Line Commanded by Col Sprout into a company commanded by Capt Ballard. In this Regt I served until Sept 1783 + then was discharged my discharged was signed by Gen'l Knox. I never was in any Regular Battle: but in several skirmishes. I am by occupation a farmer + owing to infirmity of body am incapable of attaining a living by my labor: having never performed a days work in a day for seven years past; I made my original declaration before Martin Kinsley Esq on the 4th day of April 1818.