KNOW ALL MEN BY THESE PRESENTS, That we, Thomas Jones and John Brown, of the City of Chicago, the County of Cook, and the State of Illinois, are held firmly bound unto Richard Roe, of the same place aforesaid, in the sum of Five Hundred Dollars, for the payment of which, well and truly to be made, we bind ourselves, our heirs, administrators, jointly and severally by these presents.

IN WITNESS WHEREOF, we have hereunto set our hands and seals, on this the 15th day of June, 1914.

THE CONDITION OF THE ABOVE OBLIGATION is such, that whereas (Here insert the nature and terms of the obligation, entered into by and between the parties) now if the said Thomas Jones shall perform all the covenants above mentioned, then this obligation to be void; otherwise to remain in full force and effect.

(Seal) THOMAS JONES, (Seal) JOHN BROWN.

In the presence of HOWARD SHERMAN.