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FORM NO. 121.

Names of all deceased American citizens, including seamen or mariners, together with the value of the personal effects belonging to them, and taken possession of by or deposited with

Consul at

-, from

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inclusive.

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United States (Paragraph 377.)

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vessel be-deceased.
longing.

Disposition made thereof.

FORM No. 122.

Abstract of the names and description of persons to whom passports have been issued at the Consulate of the United States at·

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inclusive. (Paragraph 377.)

—, from·

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NOTE. This return to be made every six months to the Department of State.

If the individual is a native citizen of the United States, the abstract should give his place of birth; if naturalized, the date of naturalization, the place where, and the name of the court by which a certificate of naturalization was granted, should be stated.

When husband, wife, and minor children expect to travel together, a single passport for the whole will suffice. For any other person in the party a separate passport will be required.

FORM No. 123.

Names of persons employed at the United States Consulate at

(Paragraph 377.)

Name.

Place.

Of what coun-
try a citizen or Rank.
subject.

Date of Date of nomination. approval.

NOTE. This Form should be sent to the Department always at the close of the calendar year, in order that the printed list of Consular Officers may be corrected

Total

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FORM No. 124.

Detailed list of seamen or mariners shipped, discharged, or deceased, at the Consulate of the United States at

--, from

inclusive, and the payments made on account of each.

378 and 409.)

to

(Paragraphs

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Statement of hospital dues collected at the United States Consulate at

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U. S. CONSULATE AT

I hereby certify that the above statement contains a true and correct return of all moneys received by me as hospital dues during the period therein mentioned.

[Seal of Consulate.]

U. S. Consul.

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FORM No. 126.

Return of seamen who have come upon the Consulate otherwise than in the employment of vessels or by regular discharge therefrom. (Paragraph 378.)

CONSULATE OF THE UNITED STATES AT

To the FIFTH AUDITOR OF THE TREASURY,

Washington, D. C.:

18-.

SIR: In accordance with instructions, I here with transmit the following list of American seamen who have come upon this Consulate otherwise than in the employment of a vessel or by regular discharge therefrom during the quarter ending this day.

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RETURN OF IMPORTS AT A MARITIME CONSULATE. (Paragraphs

380 and 381.)

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FORM NO. 128.

RETURN OF EXPORTS AT A MARITIME CONSULATE. (Paragraphs 380 and 381.)

Statement showing the exports from -, for the year ending 18-.

Description.

Value, includ

Quantity. (Re- ing costs and

duced to Amer-charges. (Re- Countries whither exported. duced to Amer.

can measure

ment.)

ican dollars.)

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