Single leaf, measuring 5½ × 7⅞ inches (14 × 20 cm), with sixteen lines printed in blue ink. The top and left sides of the recto have been cut or torn from a larger sheet of paper. A second promissory note to dated 22 October 1842 was written on the larger sheet above this note; the two notes were likely torn apart after being signed. At some point, the document was trifolded and then folded in half widthwise. The note contains black ink and graphite notations.

After signed the note, likely retained it until 14 August 1846, when the bond accompanying this note was canceled. The note was then returned to the trustees-in-trust for the church, who presumably retained it among their financial papers. The Church Historical Department (now CHL) published a register of the JS Collection in 1973. Between 1974 and 1984, staff continued to locate documents authored by or directed to JS, likely including this one, in uncataloged church financial records and in name and subject files. The department also acquired additional JS documents from donors, collectors, and dealers. These newly located and acquired documents were kept together in a supplement to the JS Collection. A preliminary inventory of the supplement was created in 1992. This group of records was named the JS Collection (Supplement), 1833–1844, and its cataloging was finalized in 2017.