To the Rt Worsppll. his Matys Justices of the Peace for the
County of Middx

The humble Peticon and Appeal
of Henry Savege< no role > of the Parish
of St. James Clerkenwell in
the said County

Sheweth

That your petitr is rated for Stock of prsonall
Es [..] rate of the said Parish.
[..]

[..]
[..] from the said
[..] Court Shall
[..]