Bailpiece to be Furnished a Surety in a Jail Bond Taken on an Execution
STATE OF VERMONT, On the ......... day of .........................................
......................... County, ss. } A. D. 20 ......... , A. B. of .........................................
in the county of .................... was bailed by C. D. of .................... in the county of ......................... , to the liberties of the jail yard in .............................. in the county of ............................. , on an execution in favor of E. F. of ............................................. in the county of ............................................. , the sum of ................. dollars damages, and .............................. dollars costs of action, with ......................... cents for such execution, and officers’ fees thereon to the amount of .............................. .
G. R., Jailer.