To the Worshipfull His Majestys Justices of the Peace for the County
of Middlesex in their General Quarter Session of the Peace assembled

The Humble Petition and Appeal of the Churchwardens
and Overseers of the Poor of the Parish of St. George
Bloomsbury in the said County

Sheweth

That by virtue of a Pass Warrant or Order under the hands and
seals of Charles Triquet< no role > Esquire and the Reverend Sir George Booth< no role >
Baronet two of His Majestys Justices of the Peace in and for the
said County (one whereof being of the Quorum) bearing date
the Third day of Julyhasinstant Elizabeth Adams< no role > the
Wife of Benjamin Adams< no role > was conveyed from and out of the
parish of St. James at Clerkenwell in the said County to the
said Parish of St. George Bloomsbury as the Place of her Lawful
Settlement whereby your Petition conceive themselves
aggrieved

Your Petitioners therefore Humbly Appeal to this
Court against the Adjusication of the said Justices
and their said Order, and Pray that your Worships
will be ploosed to appoint a day in this present
session for the hearing and determining the said
Appeal

And your Petitioners will pray Etc