One leaf. Form is printed in light brown ink, with brown shaded fields to identify the monetary amount, the date, the date of maturity, and signature. Areas designated for manuscript insertions contain a dotted line. A double line border in brown ink is located at all recto edges of the note. Printed vertically on the left side in brown ink are five decorative circles surrounded by flowers and foliage. The middle circle, which is the largest, contains a concentric circle with hazy sky and a sailing ship on open water. Circles adjacent to the middle circle are smaller with stylized designs in them. Printed vertically in the bottom left corner of the note is “H. Benner. Phila”. “Bailey, Keeler & Remsen,” is stamped in black ink on the form. The due date is inscribed at the top of the note above the border and is partially smeared. A serial number, “1715”, is inscribed vertically in the bottom right corner. Inscribed at a later time in black ink in the bottom left corner is “D23”. Several dockets identifying the transfer of the note to subsequent parties and attempts to pay it appear on the verso. The bleed through of a strike through on the verso is distinctly visible on the recto.

It is unknown when the Lake County Historical Society acquired the Lord Sterling Papers.