Commonwealth of Kentucky
agst } Jefferson Circuit Sct
Th^os Stevens

Affiants state that on the [...] day of 1862. I, was caled by C L Stancliff Chief of the Police of Louisville I being a Notary Public of Jefferson County to take the dying declaration of a man at the W^m Tell Coffe howse between 4^th & 5 street on Market Street, in the City of Louisville, I, accompanyd Mr Stancliff to the room were the Men was Lying I informed him that he was in a dying situation and I, had caled at the instent of Mr. Stancliff who was then present to take his dying decleration and he made nowe reply I then asked him if he knew ho sthot and he said he did

A Maas

Subscribed and sworn to before me this 27th day of Octber 1862.

Jo^s Clement J P J C

Commonwealth
vs } Affadavit
A. Maas

Tom Stevens.
1862 Oct 30^th Filed in Court