Middx ss

To the Justices of the Peace assembled, att the Quartr. Sessions for the [..]
of Middx held the 12th day of Aprill 1697

This is to Certify that the 19th day of February last, came before me Robert Thornhill< no role > Esqr . one of his
Matyes Justices of the Peace for the said County John Clarke< no role > of Oxhill in the County of Narwicke
gent, To whom I tendered, in pursuance of an Act of Parliamt. Entituled an Act for a moveing purpose
and reputed Papish from the Att ye of London & Westmr. & Ten Miles distant from the same, t:
Declaracon, Menconed in a statute made in the Thirtieth year of King Charles the Second, Esq:
an Act for the more effectually preferring the Kings person & Governmt: by disableing Papish
Sitting in either house of Parliamt: who refused to Repeate make & Subscribe the said Declaracon
Vituesse my hand & Seale this 23th day of March 1696 Annoq: Regin Regis With Tert Nono.

R Thornhill