Forms 76 and 77. FORM No. 76. Certificate of shipment of seamen or mariners attached to crew list and shipping articles. (Paragraph 248.) CONSULATE OF THE UNITED STATES OF AMERICA AT I, Consul of the United States of America for and the dependencies thereof, do hereby certify that the seamen or mariners hereinafter named have been duly shipped at this port, before me, upon the terms and conditions set opposite their names, respectively, viz: I, Agreement of master to give increased wages. (Paragraph 248.) taking into con sideration the high rate of wages for seamen, ordinary seamen, cooks, and stewards, out of the port of do hereby agree and bind dollars to the dollars myself to pay, or cause to be paid, the sum of ordinary seamen, dollars to the seamen, and hereinafter named, belonging to the said vessel, as in day of and con to the creased wages, beginning from the tinuing until the termination of the voyage, agreeably to the contract of shipping articles signed by them, a certified copy of which is hereto annexed, dated Attested: [L. S.] 18-. Master. U. S. Consul. Voyage. Men's names. Form 78. FORM No. 78. Form to be used when shipwrecked seamen are picked up at sea and conveyed home, or to any other port. (Paragraph 248.) I, to the port of · merchant vessel, belonging master of the and of the burden of the under-mentioned · tons, per register, do solemnly and sincerely declare that I received on board the said vessel at part or the whole of the crew of the seamen,1 [——————, being merchant vessel, which I have heard and verily believe was on her voyage from of the burden of about tons, and was owned by to I further declare that I landed them on the day or days, place or places, set forth in the statement underneath, and subsisted them the number of days against each person expressed, making in the whole2 days; and that during the whole of such time I had my full complement of men and boys, viz: exclusive of the under-mentioned seamen, for subsistence; and in proof of the justice of the (if required) to produce my log-book, and the declaration of the mate and carpenter; and I make this solemn declaration, conscientiously believing the same to be true. I further declare that1 sel. men and boys,3 whom I now claim claim am willing were saved from the wrecked ves The words between [] must be repeated for every wrecked vessel, when more than one, to which the seamen belonged. 2 The number here is to be inserted in words at length. 3 If the full complement not on board, state how many were deficient. 4 Here insert the words "not any provisions," or (as the case may be) "the provisions specifically stated and the value thereof." Forms 79 and 20. FORM No. 79. Receipt by Consul for wages and effects of a deceased seaman. Port of Name of seaman Effects delivered, if any Date of receipt I certify that the above-named master has paid me the abovenamed sum, and has delivered to me the above-named effects, as the wages and effects of the above-named deceased. Dated this day of, 18—. Consul. FORM No. 80. Certificate of marriage. (Paragraph 277.) CONSULATE OF THE UNITED STATES, and CD, aged years, born in and now residing in presence, by were united in marriage before me, and in my to perform such a ceremony. who is authorized by the laws of In witness whereof I have hereto subscribed my name and affixed the seal of the Consulate, at this day of 18-, and of the independence of the United States the A. D. Consul. I, Forms 81 and 82. FORM No. 81. Form for authentication of signatures. (Paragraph 309.) -, Consul of the United States at 18-. do hereby --, at the foot of the paper certify that the signature of hereto annexed, is his true and genuine signature, made and acknowledged in my presence, and that the said personally known to me. is In witness whereof I have hereunto set my hand and affixed the seal of the Consulate at this day and year next above writ ten, and of the independence of the United States the FORM No. 82. U. S. Consul. Certificate that an officer is qualified to administer an oath. (Paragraph I, 309.) Consul of the United States of America at do hereby certify and make known to whom these presents shall come that before whom the annexed affidavit [oath, or declaration, as the case may be] of hath been made, is a Commissioner in the High Court of Chancery, in England, duly authorized to administer oaths and affirmations, and take declarations in lieu of oaths, and that I believe the deponent is worthy of credit, and qualified to verify the annexed affidavit. In testimony whereof I have hereunto set my hand and seal of office, at aforesaid, this -- day of in the year of our Lord one thousand eight hundred and Consul of the United States of America. Forms 83 and 84. FORM No. 83. Rent and miscellaneous expense account. Paragraph 340.) DEPARTMENT OF STATE, UNITED STATES, Το United States Consul at 18. For rent of consular office, for quarter ending this For postage on official correspondence to and from this For stationery, as per voucher No. For freight and charges on boxes and packages to and For flag, as per voucher No. For consular seal, as per voucher No. For consular press, as per voucher No. For consular arms, as per voucher No. — For record books, as per voucher No. — For binding consular letters, as per voucher No. For loss by exchange on the amount of this account, at CR. By my draft on the Secretary of State.. U. S. Consul at DR. N. B.-Be careful to sign this account, and to transmit it at or before the time of making your draft. Received of sum of $ rooms No. FORM No. 84. Voucher for rent. (Paragraph 341.) No. 1. United States Consul at the in full, for rent, for the quarter ending this day, of which are devoted solely to street, the business of the Consulate. |