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PRINTED FORMS.
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Massachusetts. Tenth Collection District.
--. This is to certify that [Daniel Childs] of the town of [Newton] ... Chas] paid the duty of Ctwo] dollars ... upon a [two] wheel carriage for the conveyance of persons ...
CBoston? 1813]
broadside. 12x18.5cm.
Printed form filled out in manuscript.
Signed by H.W.Gordon, Collector of the Revenue for the Tenth Collection District of Massachusetts; dated 1 Jan. 1814.
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