: that I last 18-, on board the18-; that I have resided in the State of since the residing at within the day of - day of ; and that I intend to return to the United States with a purpose of residing and performing the duties of citizenship therein. I desire the passport for the purpose of Oath of allegiance. Further, I do solemnly swear that I will support and defend the Constitution of the United States against all enemies, foreign and domestic; that I will bear true faith and allegiance to the same; and that I take this obligation freely, without any mental reservation or purpose of evasion: So help me God. I hereby certify that I know the above-named 18-. - person ally, and know h- to be the identical person referred to in the withindescribed certificate of naturalization, and that the facts stated in haffidavit are true to the best of my knowledge and belief. [Address of witness.] NOTE. This form is to be filled out in duplicate, one copy being retained on thei files of the legation and the other forwarded with the quarterly returns to the D partment of State. It may be so filled out by the applicant, in which case no fee therefor is chargeable. J I, 88: a naturalized and loyal citizen of the United States, tereby apply to the Department of State, at Washington, for a passort for myself, accompanied by my wife, hildren, as follows: 18-; and born at I solemnly swear that I was born at ɔf ——, 18—; that my and minor on the day of emigrated to the United States, sailing on from on or about the day of -, 18—; years, uninterruptedly, in the United States, from ; that he was naturalized as a citizen of the court of at on the United States before the day of- -, 18-, as shown by the accompanying certificate of naturalization; that I am the of the person described in said certificate; that I have resided in the United States, uninterruptedly, for years, from to, at; that I am domiciled in the United States, my permanent residence being at where I follow the occupation of --, in the State of -; that I am about to go abroad temporarily; and that I intend to return to the United States with the purpose of residing and performing the duties of citizenship therein. Oath of allegiance. Further, I do solemnly swear that I will support and defend the Constitution of the United States against all enemies, foreign and domestic; that I will bear true faith and allegiance to the same; and that I take this obligation freely, without any mental reservation or purpose of evasion: So help me God. Sworn to before me this day of 18-. Notary Public. I hereby certify that I know the above-named person ally, and know h-to be the of the person referred to in the withindescribed certificate of naturalization, and that the facts stated in haffidavit are true to the best of my knowledge and belief. [Address of witness.] Applicant desires passport sent to following address: FORM NO. 179. Certificate of deposit of passport and registry of a citizen of the United States. (Paragraph 165.) CONSULATE OF THE UNITED STATES OF AMERICA, AT Age Eyes Nose Mouth Chin Hair 189-. The undersigned Consul of the United States of America, certifies that a citizen of the United States of America, is registered in this consulate, and is the bearer of passport No. No. signed by Complexion [Signature of the bearer.] FORM NO. 180. (Paragraph 166.) Certificate to be attached to a passport application in China when a notary public or other officer authorized to administer oaths is not accessible to the applicant. I, the undersigned, do hereby certify and affirm that the matters stated in my application for a passport of date are true; and I do hereby consent that this statement shall, in all respects, be held and treated as if I had personally executed such application before a consul of the United States. Witness: FORM NO. 181. (Paragraph 167.) Travel certificate to be issued to the possessor of a passport in China. No. I, -.] Consul of the United States of America at having received an application from a citizen of the United States, for a passport to travel in the province of have, under the provisions of the Tien Tsin treaty, issued this pass, and have to request that the Chinese authorities, civil and military, on examining it, will allow Mr. safely and freely to pass, and in case of need, to give him all lawful aid and protection. Given under my hand and the impression of the seal of the consulate of the United States at Good for one year. [SEAL.] this day of 189-. U. S. Consul. FORM NO. 182. (Paragraph 167.) Travel certificate to be issued to an applicant for a passport in China. No. -.] I, Consul of the United States of America at a citizen of the by way of, to having received an application from United States, for a passport to travel from [and return], have, under the provisions of the Tien Tsin treaty, issued this pass, and have to request that the Chinese authorities, civil and military, on examining it, will allow Mr. safely and freely to pass, and, in case of need, to give him all lawful aid and protection. Given under my hand and the impression of the seal of the consulate of the United States at, this day of ——, 189—. Good only for one journey, and not longer than one year. [SEAL.] U. S. Consul. FORM NO. 183. Affidavit of consignee, declaring the delivery of tobacco or snuff at a of days of I, do hereby declare that the goods or merchandise hereinafter described have been landed at this port, between the whereof and of from on board the is at present master, viz: Which goods or merchandise, according to the bills of lading for the |