Know all men by these presents that I of the County of and State of , am held and firmly bound unto Joseph Smith of the County of and State of in the Sum of Two thousand dollars for the payment of which well and truly to be made I bind myself my heirs, executors administrators and assigns in the Sum of firmly by these presents.

Now the condition of the above obligation is such, that whereas the said has been appointed an agent by the Church of Jesus Christ of Latter Day Saints to collect funds for building a for Said Church in the City of now if the said shall make just and true returns of all monies and properties he may collect and shall well and truly pay over the same to Joseph Smith as aforesaid, without delay, then this bond to become null and void otherwise to be and remain in full force and virtue.