BY THE KING. 
Trusty and well-beloved, We greet you well.  
Having observed in the Precedents and customs of former times, That the Kings and Queens of this our Realm upon extraordinary occasions have used either to resort to those contributions which arise from the generality of subjects, or to the private helps of some well-affected in particular by way of loan; In the former of which courses as We have no doubt of the love and affection of Our people when they shall again assemble in Parliament, so for the present We are enforced to proceed in the latter course for supply of some portions of Treasure for diverse public services, which without manifold inconveniences to Us and Our Kingdoms, cannot be deferred: And therefore this being the first time that We have required any thing in this kind, We doubt not but that We shall receive such a testimony of good affection from you (amongst other of Our subjects) and that with such alacrity and readiness as may make the same so much the more acceptable, especially seeing We require but that of some, which few men would deny a friend, and have a mind resolved to expose all Our earthly fortune for preservation of the general; The sum which We require of you by virtue of these presents is _____ which We do promise in the name of Us, our Heirs and Successors to repay to you or your Assigns within eighteen months after the payment thereof unto the Collector. The person that We have appointed to collect, is _____ to whose hands we do require you to send it within twelve days after you have received this Privy Seal, which together with the Collectors acquittance, shallbe sufficient warrant unto the Officers of Our Receipt for the repayment thereof at the time limited.  
Given under our Privy Seal at _____ the _____ day of _____ in the first year of our reign of England, Scotland, France, and Ireland. 1626.