To His Excellency Beriah Magoffin Governor &c

Your Petitioner Green Selfrespectfully States, That at the May term 1861 of the Jefferson Circuit Court he bound himself as Recognisor, for the appearance of his Son Henry Self, at the next term of said Court to answer an indictment for Felony, Said Recognizance was in the Sum of $500,00 Said Henry Made default and a Scire facias has been ordered against your Petitioner requiring him to Shew cause why judgement Shall not be rendered against him for Said Sum All of which appears from a copy of the order of Said Court which is Presented herewith, and judgement will be rendered against Petitioner for said Sum as he is absolutely unable to Shew any

cause why it Should not

He States that in consequence of reverses in business, and the Suspension of trade he is utterly unable to pay said Sum, He has a wife and five Children who are entirely dependent on him for their daily bread and to exact the money or imprison him for its non Payment would result in nothing but the Suffering of his family He therefore asks your Excellency to remit said forfeiture so far as he is concerned,

Green Self

Jefferson County Sct.

subscribed & sworn to by Green Self before me, this 4^th day of Dec^r 1861.

J. S. DozierExaminer
for Jefferson County, Ky.

I ask that the prayer of the petititoner be granted

Hamilton Pope

P. B. Muir

Geo. W. Johnston

Henry Self and William Burnwere arrested charged with stealing a small lot of cigars, and held to answer as above stated, His father & mother became his bail suretys, Young, Self Joined a military company & went in the Confederate Army — Burns remained at home & was tried and acquitted, or a nol pros entered in his case, The facts in his case were those attending Self's, His father & mother are very poor, industrious people & are unable to pay the amt of forfeited bond

W, G Reasor

R. F. Baird

Jefferson Cir. Ct

Remitted
B M.

$500. } Recog.
Green and Susan Self
Iss^d.Dec^r. 5. 1861