Honble . Gentlemen

I beg the favour of being allowed to take
the appointed Oaths & others as a dessenting Teacher
Commonly called an Independent and it well oblidge

Honble . Gentleman

London 25 April 1775

Your most humble Servant
William Headebourne< no role >

To the Honble. his Majesties Justices of Peace or the County
of Middlesex met at she is Quarter Session