To the Right Worsph her Matys
Justices of the Peace for ye County of Middx

The humble Peticonr of Lawrence
[..] son at the Parish of St James Clerkenwell
in the said County

Sheweth

That yor Petitr rated Six Pence P Month towards the
Relief of the Poor of the said Parish But forasmuch as yor
Petitr being a Poor Man & having no other Dependency
for ye Mainteynance of himselfe and family then only being
in Journeyman Taylor And having never before been Rated
towards the Relief of the sd Poor [..] yor Petr. being Aged
Fifty Five yeares is not able to Pay ye said Rate

P Tho: Nash< no role >

Your Petitr therefore most
humbly Prays yor Worships to be pleasd
to granty she may he Discharged from
the said Rate

And yor. Petr shall ever pray Etc