To the Rt: Worsppll: his Maties Justices of the Peace for the County of Middx

The humble Peticon & appeal of William Smith< no role > of
the Parish of St Giles without Cripplegate
in the Said County.

Sheweth

That your Petitioner hath Lived in the said Parish Tenn Yeares &
[..] upwards and never was rated towards the Relief of the Poor thereof
But about a Fourtnight agoe the Churchwardens came to your Petitr.
and Demanded four Shillings And upon Nonpayment thereof made
Distresse on your Petitrs. Goods:

That your Petitr: is a very poor Infirme man and hath an
Aged Wife to Mounteyne By meanes whereof he is not Able to
pay the said rate or any part thereof

Your Petitr: therefore humbly prays Your
Worshipps will be pleased to order that
he may be wholly Discharged from paying
towards the said Poors Rate And that
his Goods doe Distreined may be restored
to him againe If your Worshipps soe thinke.
fitt

And Your Petitr: shall ever pray Etc

Wm: Smith< no role >