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Dated this ................ day of ................ A.D. ........, at ................ .
Dated this ................ day of ................ A.D. ........, at ................ .
I do hereby command you, the said keeper, to receive the defaulter into your custody in the said prison and imprison him for the term of ................, unless the said sum and the costs and charges of the committal and of conveying the defaulter to the said prison are sooner paid, and for so doing this is a sufficient warrant.