To the Right Honble. Sr Richard Levitt< no role > Knt Lord Mayor of the
City of London & to the Rest of his Maties. Justices of the Peace for
the said City Assembled in Quarter Sessions

The humble Peticote & Appeal of the Churchwardens &
Overseers of the Poor of the parish of St Giles in the Fields
in the County of Middlesex

Sheweth

That by a Pass bearing date the 26th: day of March last past under the hands & Seale
of Sd Salathiel Levell< no role > Knt & Sr Thomas Lane< no role > Knt two of his Maties. Justices of the peace for the
said City one Joseph Cooper< no role > an Infant aged about 18th Months was Sent from the parish
of St Andrew Holborn London to the said parish of St Giles in the Fields as the last
place of the legall Settlement of the said Infant

Your Peticoner thinks themselves [..] by the Judgment of the
said two Justices & do therefore appeale to this honble. Court & humbly
pray that the Churchwardens & Overseers of the poor of the parish
of St Andrew Holborn & all other parishes concerned herein may be
Ordered to attend this Court to here & abide the Judgment & finall
determination thereof touching this Appeal

And your Peticonr: (as in duty bound) shall on pry etc