Formulaire utilisé entre 1899 et 1903
(Disponible en anglais seulement)
Date (or Port) of Embarkation
Names of Passengers
Adults
Age
Male
Female
Children between 1 and 14
Age
Male
Female
Number of infants not over 1 year
Passengers who are heads of families on board
No. of persons belonging to the family
Adults
Children under 14
Passengers not belonging to any family on board
Profession, Occupation or Calling of Passengers
Nation or Country of Birth
Births at Sea
Deaths
Places of ultimate destination of passengers, excepting "Tourists" and
"Returning Canadians" who are to be so described