X J.Q. Leonard,
Zera Fairman, X
Russell Blakely. X
** Names struck off by plaintiff checked on the right; by defendant checked on the left.
W.D.D., Justice of the Peace.
VENIRE.
State of __________,}
County of _________}ss.
The State of __________ to the sheriff or any constable of said county:
You are hereby commanded to summon (here insert the names in full), to be and appear before the undersigned, one of the justices of the peace in and for said county, on the ______ day of __________, 18______, at ______ o'clock in the ______noon of said day, in the (town) of __________, in said county, to make a jury for the trial of a civil action between J.T., plaintiff, and A.M., defendant, and have you then and there this writ.
Given under my hand this ______ day of __________, A.D. 18______.