This day personally appeared before me, a justice of the peace within and for the County of the subscriber , who being duly sworn doeth depose and say that on the night of the sixth day of May 1842 while sitting in his dwelling in the town of in the County of , he was shot with intent to kill, and that his life was dispaired of for several days, and that he believes and has good reason to believe from evidence and information now in his possession, that a citizen or resident of the State of is the person who shot him on the night of the aforesaid, and the said deponent hereby applies to the of the State of to make a demand on the of the <​State of​> to deliver the said to some person authorized to receive him and Convey him to the County aforesaid there to be delt with according to law.

[p. [1]]