State of Illinois,
Shelby County
John W. Field being duly sworn, deposeth any [sic] saith that Benj R. Field late of the town of Shelbyville in the county of Shelby and State aforesaid, departed this life at Shelbyville in said county, on or about the 10- day of May A. D. 1903 and that he died leaving a last will and testament to the best of my knowledge and belief.
John W. Field
Subscribed and sworn to before me,
16- day of June, 1903.
Albert Allen Clerk.
