I, merchant-vessel FORM NO. 21. Waiver of extra wages. (Paragraph 195.) a seaman, this day discharged from the United States -, with my own consent, do hereby waive any and all claims to the one month's extra wages which would otherwise be coming to me by law, and do authorize Consul of the United States at Order to send seaman to hospital. (Paragraph 238.) CONSULATE OF THE UNITED STATES OF AMERICA AT 188an invalid SIR: You will please admit into your hospital destitute American seaman, requiring medical aid, for account of this Consulate. I am, sir, your obedient servant, M. D. FORM NO. 23. U. S. Consul. Certificate given to masters whose seamen leave hospital against physician's advice. (Paragraph 238.) CONSULATE OF THE UNITED STATES OF AMERICA AT I, the undersigned, Consul, etc., do hereby certify that who has been duly shipped before me in the - —, of master, was sent to the hospital at this port by me upon his own application, and, after being examined by the attending physician of the said hospital, was pronounced a fit subject and duly admitted to be cured of the disease. That, contrary to the advice and opinion of the said attending physician, the said left the hospital a few days thereafter, insisting that he was well and able to do seaman's duty and return home. That, in consequence of his ill-health and liability to go upon the sick-list at sea, several masters of American vessels refused to ship him before he entered on board of the as aforesaid; and this certificate is granted to Captain at his own request, to protect him hereafter should the said in consequence of the disease aforesaid, he unable to perform the duty required of him as a seaman on the voyage from this port to Given, etc. FORM NO. 24. U. S. Consul. Certificate given by consular officers to masters of vessels transporting to the United I, the undersigned, Consular Officer of the United do hereby certify that I have sent to ican tons burden, whereof (full name) the following-named destitute American seamen: Names of seamen. Name of vessel on which Port belonging to. and have agreed with the said master that on presentation of this certificate at the Treasury Department, bearing an indorsement of the collector of customs at the port of aforesaid, that the seamen herein mentioned have arrived in said vessel within his district, he shall and will be entitled to receive the sum of dollars for passage, being the sum of dollars for each seaman. But if the vovage shall continue beyond the period of thirty days from the date of sailing, and it shall be so certified by the collector of customs, the said master shall and will be entitled to receive the sum of dollars for their passage, being the sum of dollars for each seaman, in conformity to section 9 of the act of June 26, 1884, and section 18 of the act of June 19, 1886. And I further certify that the regular charge for a steerage passage on said vessel from this port of - in the United States, is $ the distance is miles. Given under my hand and seal of office this day of and that U. S. Consul.* *If the vessel is a foreign one its nationality must be stated in this certificate by the Consular Officer, with the reason for engaging passage thereon instead of on an American vessel. Whenever a seaman is unable to perform duty the Consular Officer must state on this certificate the nature and cause of his disability, and what in his opinion will be a fair and reasonable allowance in addition to the rate fixed by law for the passage of a seaman who can perform duty. CUSTOM-HOUSE, COLLECTOR'S OFFICE, 188-. I hereby certify under seal of my office that the seamen, to the number of —, named in the within consular certificate, have arrived within this district in the within-named vessel, of tons burden, as per register on file in this office, and that he voyage from covered a period performed no duty on the voyage by reason of days, and that* of inability. [SEAL.] FORM NO. 25. Monthly abstract of bills of health. (Paragraph 338.) Abstract of bills of health issued at · during the month ending · Collector. 188-. Remarks.† Number of deaths from yellow fever at this port during the week ending U. S. Consul. FORM NO. 26. Affidavit or certificate of attending physician. (Paragraph 249.) I hereby swear (or certify, as the case may be) that A B, C D, and E F, sick American seamen, were attended by me during the quarter ending the day of 188-, and that the health of the said named persons was such during that time that it would have endangered their lives to have sent them on their homeward voyage. *The collector will insert the names of seamen who have been unable from sickness to perform duty. Here state whether vessel was at infected docks, number of days or hours in port, and such other facts as may be of importance. 765 C R-37 FORM NO. 27. Complaint by crew of bad quality or insufficient quantity of provisions or water. (Paragraph 282.) The undersigned, three or more of the crew of the a merchantship of the United States, complain that the provisions [or water] [or both] for the use of the crew of the said vessel are of bad quality and unfit for use [or are deficient in quantity], and request an examination of the same according to law. Dated at the day of 188-. 9 [Signatures.] FORM NO. 28. Notice to master of result of examination on complaint of crew. To 282.) CONSULATE OF THE UNITED STATES AT (Paragraph 188-. ་་ a merchant-ship of the United States, master of the now in this port: I hereby signify to you in writing that on complaint made on the day of -, by -, and a part of the crew of the said vessel, I have this day examined the provisions [and water] [or either of them as the case may be] for the use of the crew of the said vessel, and have found them to be [or not to be] of bad quality and unfit for use [or deficient in quantity]. Given under my hand and the seal of the Consulate this -, A. D. 188—. [SEAL.] Entry of result of examination in log-book of vessel. (Paragraph 282. ) CONSULATE OF THE UNITED STATES AT On complaint made by a part of the crew of the -, and 18-. I have this day examined [as in form 28]. To FORM No. 30. Report to the district judge of the United States. (Paragraph 282.) CONSULATE OF THE UNITED STATES AT district judge of the United States for the district of 188-. In compliance with the provisions of Title LIII of the Revised Statutes, I have the honor to report that, on the day of 188-, and a part of the crew of the a merchant-ship of the United States then in this port, bound for the port of -, made complaint to me that [recite complaint]; that thereupon, on the day of I examined the said provisions and water, and found them [recite finding], and signified the same in writing to the master, and entered a statement thereof in the log-book of the said Witness my hand and the Consular seal at A. D. 188-. [SEAL.] the day of U. S. Consul. FORM NO. 31. Request to local authorities to imprison seamen or mariners. (Paragraphs 264, 290, and 342.) SIR: of the CONSULATE OF THE UNITED STATES OF AMERICA AT of in this port from whereof is master, recently arrived having conducted themselves in an improper and insubordinate manner on board, and positively refused to do duty, I have the honor respectfully to request that you will please cause the said named persons to be arrested, brought on shore, and imprisoned until I can find it expedient to give them their liberty. I have the honor to be, sir, your obedient servant, To Captain [or other authorities of the port]. U. S. Consul. |