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 Joseph Smith commonly called the Mormon Prophet was accessary before the fact of the intended murder; and that the said Joseph Smith is a citizen or resident of the State of , and the said hereby applies to the of the State of to make a demand on the of the State of , to deliver the said Joseph Smith commonly called the Mormon Prophet to some person authorised to receive and convey him to the and aforesaid, there to be dealt with according to Law.

Sworn to and subscribed before me this 20th. day of July 1842