Formulaire utilisé en 1906 et 1907
(Disponible en anglais seulement)
No. of S.S. Contract Ticket. Amount of Cash . To be filled in by Immigration Agent at Port of Landing. Name of Passenger. Age of Adults. Male. Female. Children under 14 years of age. Able to Read. Write. Married or Single. No. of Passengers. Profession, Occupation or Calling of Passengers. Nation or Country of Birth. Births at Sea. Deaths at Sea. Place of ultimate destination of Passengers excepting "Tourists and
returned Canadians," who are to be so described.