ID Il


Form Of .9H1Grit so De taken is
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Form Of .?fia7is to Be taken is Attorneys.
Before me, - Justice of the Peace in The cotny of
-, in the Of -~, personally appeared this day,
49, the attorney named in the foregoing power Of ator-
new and made oath that the not given him by
reason any ranser Of any attachment levy sezure
by any legal process whatever of the pay therein authors
zed to be received but that the said pay intended to
enure wholly the personal benefit of the pergon BY whom
the said power was executed.


Witness my hand, this - day Of -, in the year
Before me, -, there insers either a Justice Of the
Peace or other Magistrate, duly empowered to adninse.
oa,lsl in the County of , in the State of - person.
ally appeared, This day, and OF the said county,
who did severay, make oath, that -, by whom the
foregoing declaration subscribed, is generally reputei
and believed to have been Officer in the Army or The
Revolution, in as therein stated


Witness my hand, this - day Of -, in the year -.


lsgnedl


t., Clerk OF the Court Of the County off,, in The
State of -, do hereby certify, that - before wlor,
the foregoing adayits sworn at the tne hefc
insert either usoe Of the Peace other Magistrate.
duly empowered TO administer caihs and duty empower
ed to administer oatls.


In testimony whereof, have hereunto set nj hanG,
H. 81 and affixed the seal Of the saj Court, this


day of , in the year -.


[signedl


ITO be published once week for two months ii Tie
papers authorzsdo publish the Laws thu United States
tcns s. a.