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� I Thomas Burkman on oath say and declare that I have no real nor Personal Estate or any income whatever except my necessary Bedding and wearing apparel, except one cow and one pig I am a farmer for profession but an unable to labour I have no children residing with me subject to my control -- and I am unable to support myself without the aid of private or public charity and without my pension I must throw myself upon the Town for my support

Thos Burkman[signature]