One leaf, measuring 11½ × 7½ inches (29 × 19 cm). The leaf was originally the first leaf of a bifolium of these same measurements, but the second leaf was cut off. The recto contains four promissory notes, of which the text featured here is the first; the verso is blank. The second bifolium leaf, still located with the first, is blank on the recto and contains a fifth promissory note on the verso.

The note may have been submitted as a freewill offering or tithing to . The document, along with many other personal and institutional documents kept by Whitney, was inherited by his daughter Mary Jane Whitney, who married Isaac Groo. This collection was passed down in the Groo family and donated by members of the family to the Harold B. Lee Library at Brigham Young University between 1969 and 1974.