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

The humble Petition and Appeale
of Christopher Jefferson< no role > of the
Parish of St James Clerkenwell
in the said County.

Sheweth

That your Petitr: is rated in the poors rate of ye sd.
Parish for the house he dwells in after the
yearly rent of four pounds Whereas Yor. Petr.
pays noe more then Six and Fifty Shillings
P Ann rent and Appeals agt Ye same
That your Petitr: being an Aged man
and past his Labour and having an aged
wife & being very Poor.

Humbly Prays he may be wholly
Discharged from paying to ye said
poors rate

And Yor Petr. shall Ever pray Etc:

Chris: Jefferson< no role >