This scanned image is the obverse of a printed form (opposite side had the attorney's statement of disinterest) for the claim by the heirs of Elizabeth Hooper, widow of James Hooper. An embossed seal obscures some of the writing on the top left side. This form twice names the heirs of Elizabeth Hooper. The dark shadow at the bottom of the page results from an attached certification which has darkened significantly through the years. The attached certification, therefore, cannot be reproduced herein. For content, however, check the full transcription on the final page.

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