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CONSULATE OF THE UNITED STATES OF AMERICA AT

189— [, the undersigned, consul of the United States of America, etc., do reby certify that

having taken and subscribed the oath quired by law, is at present master of the of -- in lieu of

the former master. Given, etc.

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U. S. Consul.

FORM No. 20.

Declared-export return.

(Paragraphs 586,587.) tatement showing the declared value of exports from the consular district of

the United States during the four quarters of the year ended

to

Quarters ending

Articles.

Total for the year.

Septem. December March 30, ber 31,1884. 31, 1885. 1885.

June 30,

1885.

U. S. Consul. NOTE.—This form is to be filled up and sent to the Department of State at the end of each fiscal year. The articles of export are to be arranged in alphabetical order.

FORM No. 21.

Certificate for cancellation of crew bond.

(Paragraph 197.)
CONSULATE OF THE UNITED STATES AT

189SIR: The accompanying list contains the names, places of birth, residence, and description of persons composing the crew of the -, of

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whereof

is master, granted in the district of on the day of

189—, and shows who of said crew have been discharged by me, or who have died, absconded, or been ford impressed into other service. New articles have been certified in place of those certified at your port. Respectfully, yours,

U.S. Consai To the COLLECTOR OF CUSTOMS,

Port of , United States of America.

FORM No. 22.

Order to send seaman to hospital.

(Paragraph 272.)
CONSULATE OF THE UNITED STATES OF AMERICA AT

189 SIR: You will please admit into your hospital

, an in Tald destitute American seaman, requiring medical aid, for account of this Consulate.

I am, sir, your obedient servant,

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Certificate given to masters whose seamen leave hospital against

physician's advice.

(Paragraph 272.)
CONSULATE OF THE UNITED STATES OF AMERICA AT

189
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, be unable to perform the duty required of him as a seaman on the voyage from this port to

Given, etc.

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U. S. Consul.

FORM No. 24.

Certificate given by consular officers to masters of vessels transporting to

the United States destitute American seamen.

(Paragraph 282.)

CONSULATE OF THE UNITED STATES OF AMERICA.

-, 1894 I, the undersigned, Consular Officer of the United States of America at -, do hereby certify that I have sent to

on board the American tons burden, whereof (full name).

is master, the following-named destitute American seamen:

Names of seamen.

Name of vessel on which

they last served.

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 voyage 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

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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 $, and that the distance is miles. Given under my hand and seal of office this

day of 1894

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Custom-HOUSE, COLLECTOR'S OFFICE,

189I 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 the voyage from corered a period of days, and that performed no duty on the voyage by reason of inability: [SEAL.]

Collector.

Form NO. 25.

(Omitted.)

FORM No. 26.

Affidavit or certificate of attending physician.

(Paragraph 284.) I hereby swear (or certify, as the case may be) that A B, CD, and EF, sick Am can seamen, were attended by me during the quarter ending the day of

-, 189—, 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.

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M. D.

i 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 passara of a seaman who can perform duty.

Form No. 27.

om plaint by crew of bad quality or insufficient quantity of provisions

or water.

(Paragraph 316.)

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Consul of the United States at The undersigned, three or more of the crew of the a merchant hip of the United States, complain that the provisions (or water] [or oth) for the use of the crew of the said vessel are of bad quality and infit for use (or are deficient in quantity], and request an examination f the same according to law. Dated at the — day of

189—

[Signatures.]

FORM No, 28.

Notice to master of result of examination on complaint of crew.

(Paragraph 316.)

CONSULATE OF THE UNITED STATES AT

189—

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To

master of the a merchant ship of the United

States 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 erew 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 day of

A. D. 189— [SEAL.)

U. S. Consul. 17824 CR-46

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