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(Here name all articles of clothing furnished, in-
cluding cost thereof)

Delivered in presence of

Correct:

DR.

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during the quarter ending

DR.

For burial expenses of the following-named destitute American

seamen, who died at

of, 18-:

November 22,

day

$4.00

November 26,

4.00

8.00

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FORM NO. 99.

RETURN OF EXTRA WAGES. (Paragraph 359.)

United States Consul at

in account with the United

to

States Government, for amount of the one month's extra wages received on account of discharged seamen, from

DR.

18-.

CR.

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FORM No. 100.

ACCOUNT-CURRENT. (Paragraphs 360 and 411.)

The United States Government in account-current with

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United States Consul at

CR.

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6 112 00

By 1 month's extra wages By portion of 2 months' ditto..

By amount of draft on the Honorable

State, at 15 days' sight, in favor of acceptance waived.

Secretary of

132 00

December 31, 1870.

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Date. No.

FORM NO. 101.

RECORD OF TREASURY FEES, (Seaport Consulate.) (Paragraphs 325, 362, and 401.)

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On the

day of

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before me, the undersigned, perUnited States Consul at

sonally appeared and made oath that the above and foregoing account or report of fees is a full and perfect transcript of the register which he is by law required to keep; that the same is true and correct, and contains a full and accurate statement of all fees received by him as such Consular Officer, or for his use, for his official services, to the best of his knowledge, during the period of time therein mentioned.

Sworn to before me,

United States Consul.

NOTE. This Form is to be followed by Consular Officers residing at seaports, and a transcript thereof transmitted to the Secretary of the Treasury.

Remarks.

FORM No. 102.

RECORD OF TREASURY FEES, (Inland Consulate.) (Paragraphs 325, 362,

and 401.)

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NOTE.--This Form is to be followed by Consular Officers residing at inland places, and a transcript thereof transmitted quarterly to the Secretary of the Treasury.

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