翻刻
置候処只今御渡慥請
取申候右此方え取置候
手形紛失申候間重而手
形尋出候共可為反古者也
仍反リ手形如件 誰判
年号月日 誰殿参
質入銀子借用手形
一銀何百匁
右之通リ受取申所実正明
白也利は一ヶ年ニ何程ツゝ急
現代語訳
置いた所、只今お渡しいただき確かに受け取り申し候。右の件につき、こちらで取り置いていた手形を紛失いたしましたので、重ねて手形が見つかりましても反故とするべきものです。
よって返済手形、件の如し 誰々（印）
年号月日 誰々殿参
質入れ銀子借用手形
一、銀何百匁
右の通り受け取り申すところ実正明白なり。利は一ヶ年にいくらずつ
英語訳
Having deposited [the silver], I have now received the repayment and hereby acknowledge receipt. Regarding this matter, since I have lost the promissory note that was kept on my side, even if the note should be found again later, it shall be considered null and void.
Therefore, this repayment receipt, as stated above [Signature/seal of someone]
[Year] month day To [someone] sir
Pawned silver loan promissory note
1. Silver [several hundred] monme
Having received the above amount, this is truthful and clear. The interest shall be [some amount] per year