Declaration to be made before the Superintendent of Mercantile Marine or oths Office
at the Port to which the Seamen are ordered to be conveyed.
Date when Subsistence
Particulars of Ship in which
Names of
the Distressed Seamen were coureyed.
Seamen received on board,
on board commenced
If landed, where?
Dale when landed
No.
Dau
If not landed, cause to be stated, for disposed of submittal
Balances of Wages.
he Officer must then fill up the following form with regard to such of the Seamen as are stated by the Consul or other Officer at the port from which the order for conveyance was issued to have a balance of wages applicable to the cost of conveyance,
Names of Seamen.
Balance of Wages applicable to Cost of Conveyance.
* Cost of Conveyance.
Balances the to Seamen.
+ Signatures of Seamen in acknowledgment of receipt
of balances duo.
Name
Official No.
Tonnage
No. of Crew
on Outward
Voyage
No. of Crew
on Homeward
Voyage
Total No. of Days
If the Seainen are described by the Consul or other Officer abroad as shipwrecked, or left behind illegally, the cost of conveyance is not to be deducted from the balance of wages.
If the Seaman is described as injured in the service of the ship, the cost of conveyance is to be deducted from his wages in the following cases only--
1. If the Vessel in which be last served shipped him at a Foreign Port:
2.
If shipped in the United Kingdom and conveyed to a British Possession abroad:
3.
If shipped in a British Possession abroad, and conveyed to any other British Possession, or the United
Kingdom.
Master of the above-nang
Ship, do solemnly and sincerely declare that the Seam n above referred to w subsisted b te for the period stated, during the whole of which time I had my full complement of ma [excepting
], exclusive of the aforesaid Seam n, and
that the above statements are correct.
Declared before me at
this
day of
18
7
Hasel Siymatne
Masters Addres
+ When a Seaman cannot write, his mark must be attested by an uninterested witness, other than the Paying Officer.
Witness to payment.
When the foregoing payments are made, and the receipts taken, the payments should be entered in Schedule 80, and this Form forwarded at once to the Board of Trade. An Officer abroad should charge the payments in his Quarterly Account with which this form should be sent as a voucher.
The following form should also be filled up.
Summary of Payments.
Officer's Signature.
This Form is now to be delivered by the Master of the Ship to the Superintendent or other Officer, who will examine it earful making reference to the Ship's papers and inquiries of the Seamen conveyed. If the Superintendent or other Officer thinks th there is any reason to doubt the correctness of this Declaration, or any of the particulars, he will refuse payment, and reperi iz matter to the Board of Trade, with full explanations of his reasons for so refusing. If there is no reason to doubt the correctness a the particulars given by the Master, and the claim is usual and in order, he will then calculate the amount to be paid according å his instructions in Circular, No, 418, and pay the same to the Master, first filling up the following Certificate :—-
Certificate of the Superintendent of Mercantile Marine or other Officer at the Port
where the Seamen are Landed, and Receipt of Master for Conveyance.
Conveyance
Balance of Wages
Number of Distressed Seamen conveyed.
Total Nuraber
Rate
of Daye subsisted.
per day.
Amount.
3 Certify that the sum of
shillings
pourds
Total
pence
11.
Dated this.
is due for the conveyance of the above-named
Seam
Charged in Schedule 30 for the month ending.
18
DEDUCT-
day of
ዕት
18
Charged in account with Board of Trade for Quarter ended,
For
n deficient in con-
... Superintende
plement of Crew
days
Received the above amount this.
day off
Paying Offeer's
Nignature.
18
Office
Masie
Port.
554
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