The Worshipfull his Majesty's Justices of the peace for the County of Middlesex
General Session of the Peace at Hicks Hall in the said County Assembled.

The humble Petition and Appeal of the Church Wardens and
Overseers of the Poor of the Parish of Saint Anne within the
Liberty of Westminster in the County aforesaid.

Sheweth

That by Virtue of a pass Warrant or Order under the hands and Seals
of Philip Dyot< no role > and John Girdler< no role > Esquires two of his Majesty's Justices of the
peace in and for the County of Middlesex (whereof one is of the Quorum) bearing
Date the eighteenth Day of January last Samuel Robinson< no role > Peruke-maker
and Elizabeth< no role > his Wife were removed and conveyed from that part of the Parish
of Saint Andrew Holborn which has above the Bars in the County of Middlesex
[..] said Parish of Saint Anne as the place of their last legal Settlement whereby
[..] Petitioners conceive themselves to be aggrieved.

Your Petitioners therefore humbly Appeal to the Court
against the Adjudication of the said two Justices and their
said Order and pray that Your Worships will please to appoint
some Day in this present Session for the hearing and
determining the said Appeal And to Order that the Church-
Warden and Overseers of the poor of the said part of the
Parish of Saint Andrew Holborn and all persons concerned
do then Attend this Court.

And Yr: Petitrs: shall pray Etc

Jno: Gerard< no role >
Wm. Stedman< no role > }
Church Wardens
and

N: Horwood
Lewis Gilles< no role >
S: Goddard
W. Peale}
Overseers of the Poor
of the said Parish
of Saint Anne