FIRST NAME

LAST NAME

LOCALITY

   
TheShipsList Home Page Search the Passenger Lists Search Ship Company Fleet Lists Ship Descriptions and Voyage Histories  
Find Pictures of Ships, Ports, Immigration Stations
Find Diagrams & Photographs Ships' RiggingSearch Ship Arrivals from Newspapers &c
             
 
Search Marriages at Sea, British Ships
Search Numerous Files for Famine Emigrants, 1847Find Reports & Lists of Ship Wrecks Search 1862 Lists & Shipping Information Search Immigration & Ship Related Off-site Links              
Diaries & Journals | Immigration Reports | Illustrated London News | Trivia | Frequently Asked Questions
 

Return to Canadian Records

Form 30A (Original)

Form 30A (ORIGINAL)

S.S. __________________ CLASS _______ DATE OF SAILING _____________________

                              DECLARATION OF PASSENGER TO CANADA

1. Name ________________________________________________ Age _______________

2. Sex _____ Are you married, single, widowed or divorced? _________________________

Are you accompanied by husband or wife? If so, give details of husband or wife ___________________________________________________________________________

3. Present Occupation ___________ Intended Occupation __________________________

4. Birthplace ____________________ Race or People ______________________________

5. Citizenship ___________________ Religion ____________________________________
                                                                            (if Protestant, state denomination)

6. Object in going to Canada __________________________________________________

7. Do you intend to stay permanently in Canada? __________________________________

8. Have you ever lived in Canada? ______________ If you have, give Canadian address ___________________________________________________________________________

Port of first arrival in Canada __________________________Date ____________________

Port of last departure from Canada _____________________ Date ____________________

9. Why did you leave Canada? _________________________________________________

10. Money in possession belonging to passenger __________________________________

11. Can you read? __________ What language? __________________________________

12. By whom was your passage paid? ___________________________________________

13. Ever refused entry to or deported from Canada? ________________________________

14. Destined to? ____________________________________________________________

___________________________________________________________________________

_______________________________________________________________________
(If known relative, friend or employer {1} state which, and if relative, give relationship {2}
give his or her name and Canadian address {3} If not joining any person in Canada, give
your own Canadian address)

15. By which Canadian railway are you travelling to destination? ______________________

16. Nearest relative in country from which you came _______________________________

___________________________________________________________________________
(name) (relationship)

___________________________________________________________________________
(give full address of such relative)

17. Are you or any member of your family mentally defective? ________________________

Tubercular? _______________ Physically defective? _______________________________

Otherwise debarred under Canadian Immigration law? ______________________________

(Before answering question 17, see the prohibited classes named in Immigration Booklet 30A
which be handed to you by booking agent)

I declare the above statements are true. I am aware that a false statement constitutes
misrepresentation, and that the penalty is a fine, imprisonment or deportation.

Signature of passenger _______________________________________________________

I hereby declare that the above is the signature of passenger, and that I have handed passenger
a copy of Immigration Booklet 30A

Signature of booking agent _____________________ of ____________________________

---------------------------------------------------------------------

LANDING CARD

NAME ________________ AGE __________

SS ________________________________ (date stamp)

CLASS ______________________________

___________________________________________________________________________

(reverse)

BOOKING AGENT OR EXCHANGE OFFICE TO FILL IN THIS SPACE

Is Passengers ticket cash or prepaid __________________________________________

Date and number of ticket issued _____________________________________________

Place ____________________ Name of agent __________________________________

If prepaid order, give following information regarding exchange of the order

Place ___________________________________________________________________

Date exchanged ___________________________________________________________

Name of agent ____________________________________________________________

Passport number ___________________ Serial No. ______________________________

Issued by ________________________________________________________________

Date of issue ________________ at __________________________________________

Passport designates holder a national or citizen of ________________________________

 

 

(stamp - Canadian Port Agent)

 

 

Action taken (detained/admitted) Cause ____________________________

(signature) ____________________________

(examining officer)

_____________________________________________________________________

Remarks:-

TheShipsList

TheShipsList®™ - (Swiggum) All Rights Reserved - Copyright © 1997-2014
These pages may be freely linked to but not duplicated in any fashion without written consent of .
Last updated: May 08, 2006 and maintained by and M. Kohli