440 ADDENDA. 



from officiating, and has not an income sufficient for the necessary 

 support of himself and his family, the whole not exceeding* 

 and now resides at" 



WIDOW'S CERTIFICATE. 



" We, whose names are underwritten, do testify that 

 widow of late of in the Archdeaconry, or county 



of Stafford, is unmarried, aged years, and hath children, 



of the respective ages of is of a sober life and conversation, 



a member and regular communicant of the Church of England; has 

 no sufficient maintenance, stands in need of relief, and has not au 

 income in any way of more than* and that her husband 



was at the time of his death, possessed of some ecclesiastical pre- 

 ferment, or licensed to a curacy, within the Archdeaconry or county 

 of Stafford ; and now resides at" 



ORPHAN'S CERTIFICATE. 



" We, whose names are underwritten, do testify that 

 aged is unmarried, unprovided for, and in no way of providing 



for self, behaves decently and soberly, and frequents the ser- 



vice of the Church of England, and has not an income in any way 

 of more than* and that his (or her) father was at the time 



of his death possessed of some ecclesiastical preferment, or licensed 

 to a curacy, within the Archdeaconry or county of Stafford, and 

 now resides at" 



" N. B, It is expected that these forms will be adhered to, other- 

 wise the certificate will not be admitted. 



" Q^ The Governors of this Charity expect, at their next and all 

 future annual meetings, an acknowledgment from every person re- 

 lieved, specifying the sum. The acknowledgment may be made, if 

 the application is continued, at the foot of the fresh certificate. 



" All persons who are disposed to contribute by will to this 

 charity, are desired to do it in the following manner : 



" I give and bequeath to A. B. and C. D. the sum of****, upon 

 trust, that they pay the same to the Treasurer for the time being of 

 the Charity for the Relief of Widows and Orphans of Poor Clergy- 

 tnen, within the Archdeaconry and county of Stafford, which sum I 

 charge upon my personal estate, and desire it may be applied to 

 the use of the said charity." 



The total of receipts in 1816, was > 426. 4s. 4cf. and of disbar- 

 ments ,426. 2s. Sd. making a balance in the hands of the treasurer 

 of only one stalling and eightpence. 



* ll&re insert the particulars of the income (if any} and how it arises. 



