Received then of [blank] for and on the behalf of h[blank] landlord, the sum of [blank] so much being assessed and charged upon h[blank] said landlord : for the [blank] quarterly payment of the aid granted to his Majesty King William the Third, by virtue of an Act of Parliament made in the tenth and eleventh year of His said Majesties reign, intituled, An Act for granting to His Majesty the sum of one million, four hundred eighty four thousand, and fifteen pounds, one shilling and eleven pence three farthings, for disbanding the army, providing for the Navy, and for other necessary occasions. We say received the said sum of------ by us