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State of Tennessee} this {insert symbol:}day personally appeared Franklin County } before me {illegible: Chad?} Long as acting Justice for said {insert symbol:}County {illegible: on? will?} Bill and made with in due form of leave that he has lost or misplaced a promissory note of ninety dollars & some cents {written above: 82 cents} on Charles Barney made payable to D C Smith due about the 22 day of Oct'r {insert symbol: with a small credit}1860_ this Jany 28,, 1861 sworn to & subscribed before me this Jany 28,, 1861
{illegible: D?} A Long O. Bell {illegible}
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Amount to be deducted from C. R. Barney's note dated the 22nd Oct'r 1860 in favor of D. C. Smith as follows
Paid for {illegible} of Rutledge {illegible: Ma-on} $3.00 Oct'r 22 goods rec'd from CRB --- 7.00
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10.00
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Balance due on Note Eighty 82/100
Dollars up to the 28th Jany 1861
Received of C. R. Barney on the 28th Jany 1861 Twenty Dollars on said note leaving a balance due of Sixty 82/100 Dollars on said note
O Bell