Verso du formulaire 30A - Modèle B
(Disponible en anglais seulement)
Is passenger's ticket cash or prepaid
Date of issue of ticket
Place Name of Agent
If prepaid order, give following information regarding exchange of the order
Place
Date exchanged
Name of agent
Passport No. Serial No.
Issued by
Date of Issue
Passport designates holder a national or citizen of
Action taken
Detained
Admitted
Cause
Examining officer
Remarks: