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FORM No. 77.

Consul's certificate for custom-house or authorities, in case of the deviation of a vessel from the voyage. (Paragraph 248.)

CONSULATE OF THE UNITED STATES OF AMERICA AT

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I, the undersigned, Consul, &c., do hereby certify that the of master, bound from instant, laden with

to

, arrived at this port on the in a damaged state and condition, and in order to repair the said it is necessary to discharge the cargo, as appears by the note

of protest of the said master, made before me theday of 18, and the report of survey of the said vessel filed in this Consulate. I further certify that it likewise appears, from said report of survey and protest, that a part of said cargo was thrown overboard at sea on the voyage from to this port. Given, &c.

FORM No. 78.

U. S. Consul.

Certificate of ownership of a vessel. (Paragraph 248.) CONSULATE OF THE UNITED STATES OF AMERICA AT

18-.

I, the undersigned, Consul of the United States of America for and the dependencies thereof, do hereby certify that the of --, of the burden of

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tons,
and is owned by

mas

U. S. Consul.

FORM NO. 79.

Roll or list of crew when required by the captain or authorities of the

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FORM No. 80.

Order to pay, at home, seamen's wages or voyages. (Paragraph 248.)

SHIP

AND OWNERS:

On the termination of the voyage of the

18-.

, pay to

he

or order, what may be due to him for his voyage in said being this day discharged at this port by mutual consent. The said is entitled to the

lay, the ship having been out, and he having served in her, at the time of his discharge, months and days, and the quantity of oil and bone taken, including that held and shipped, as well as that now on board, being barrels of whale oil and

pounds of bone.

Witness:

Master.

FORM No. 81.

Master's acknowledgment to the same. (Paragraph 248.)

CONSULATE OF THE UNITED STATES OF AMERICA AT

;

18-.

I, the undersigned, Consul, &c., do hereby certify that, on the day of the date hereof, before me personally appeared master of the, of who, in my presence, and in presence of the witnesses thereunto, signed the foregoing order, and acknowledged the same to be correct in all of its particulars, and to be his voluntary act and deed for the purposes therein mentioned. Given, &c.,

U. S. Consul.

FORM No. 82.

Certificate of shipment of seamen or mariners attached to crew-list and shipping-articles. (Paragraph 248.)

CONSULATE OF THE UNITED STATES OF AMERICA AT

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18-.

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:

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of, 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 myself to pay, or cause to be paid, the sum of - dollars to the ordinary seamen, dollars to the seamen, and - dollars hereinafter named, belonging to the said vessel, as increased wages, beginning from the day of and continu

to the

ing 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

18-.

Attested:
[L. S. J

U. S. Consul.

Master.

FORM No. 84.

Form to be used when shipwrecked seamen are picked up at sea and conveyed home, or to any other port. (Paragraph 248.)

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do solemnly and sincerely declare that I received on board the said vessel at the under-mentioned

part or the whole of the crew of the

, merchant-vessel, which

seaman,' [--- being

tons, and was owned by

Í have heard and verily believe was on her voyage from

of the burden of about

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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: men and boys,3 exclusive of the under-mentioned seamen, for whom I now claim subsistence; and in proof of the justice of the claim I am willing (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.

were saved from the wrecked ves

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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."

When and where
landed, or how
disposed of.

Port.

Date.

Number of days

on board.

FORM No. 85.

Receipt by Consul for effects of a deceased seaman, left on board the vessel

(Paragraph

256.)

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I certify that the above-named master has paid me the abovenamed sum, and has delivered to me the above-named effects, as the money, goods, and effects of the above-named deceased, which he left on board, I having considered it expedient that the said money, goods, and effects should be delivered to me.

Dated this

day of, 18—.

FORM No. 86.

Consul.

Consular quarterly remittance of seamen's effects. (Paragraph 258.) CONSULATE OF THE UNITED STATES AT

To the District Judge of the United States for the district of

day of

On the the United States vessel

master of

I received from -, goods and effects, the property of —, a seaman on said vessel, deceased, and gave therefor the inclosed receipt. The deceased had also within the limits of my Consulate other effects not on board said vessel, as shown in the inclosed inventory. I caused the effects to be sold at auction, and now have the honor, in compliance with the provisions of the 46th section of the shipping-act of 1872, to inclose a statement of account, together with a draft on for days' sight for the balance to my debit; and to say that I hold myself ready to render any further account which you may require. Witness my hand and consular seal at

A. D. 187-.

[SEAL.]

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the day of

Consul.

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