| Servant Information | Agent Information |
| Name: Charles Webb | Name: Samuell Nash |
| Gender: male | Gender: male |
| Occupation: | Occupation: mer[chant?] |
| Place of Origin: | Place of Origin: London |
| Age: 22 | |
| Spouse's Name: | |
| Indenture Information | Servant's Parents Information |
| Date of Indenture: February 12 0 | Name: |
| Indenture Length: 4 | Occupation: |
| Signature: signed | Place of Origin: |
| Witness: William [Pasurchin?] and Jo.n Ingham | |
| Destination: Jamaica | |
| Ship: | |
| Ship's Captain: | |
| Notes: Record is damaged. The following information is missing or illegible: year of indenture, servant occupation, agent occupation. Month of indenture appears to be February. | |