2454
[Second Schedule Form No. 11 contd.]
No. 10 of 1916. Cargo.
TOBACCO.
No. of Marks. Nos. Description of cases. Nature of tobacco. Weight in lbs. Total value. Ships stores. No. of cases. Description of cases. Nature of tobacco. Weight in lbs. Total value.
Date..... (Owners, charterers, agents or master.) (Address.) (Signature of employé or agent if the above signature is that of a body corporate or firm.)