said Mr. R. Jacob Uttered the said Note
so Indersed purporting to be the Mark & Indorsement
of [..] the said Mary Jackson< no role > Knowing the
same to be as false forged & Counterfeit Mark &
Indorsement of the said Mary Jackson< no role > with
an Intent to Cheat & defraud the Informant
of the said Sum of Forty Pounds

Sworn before Us the
First Day of July
1773}

Jno Lane< no role >

Jno. Barnsfather< no role >

Willm Dawson< no role >