Verso du formulaire 30A - Modèle C
(Disponible en anglais seulement)
If money paid for through ticket or for order prepaid or exchange state:
(a) From whom purchased
(b) Date of purchase
(c) Where purchased
Give name and address of Booking Agent exchanging order prepaid or otherwise
Date of exchange 19
Passport No.
Date of issue
Issued by
Passport designates holder a national or citizen of
Action taken
Detained
Admitted
Cause
Examining officer
Remarks: