The form of a Certificate to be made at the returning of the Supplitavit, &c.
EXecutio istius brevis patet in quadam Schedula huic brevi annexa.
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EXecutio istius brevis patet in quadam Schedula huic brevi annexa.
EGo W. T. unus custodum pacis dicti Domini Regis in Com. Surri••, certi∣fico in Cancellariam dicti domini Regis, quod virtute istius brevis (mihi per A. P. in eodem brevi nominatum, primo delibe∣rati) personaliter, coram me, tali die, & anno, venire fecisse C. D. in dicto brevi nominatum, ac eundem C. D. ad sufficien∣tem securitatem, & Manu-captores pacis inveniendos, viz. C. H. de C. & S. P. de E. &c. compulisse.
In cujus rei testimoni∣um, huic praesenti Certificationi meae sigil∣lum meum apposui. Datum sexto Die, &c.