upwards Ann< no role > aged 2 years on the 2d. June last
William< no role > born on the 9th April 1792 And that She is
in indigent circumstances and unable to maintain
herself and Children and hath been so ever since [..]
her said Husband left her

Sworn the 27th day of March
1793 before me} Wm Kitchiner< no role >

Elizth [mark] Jackson< no role > 's
Mark