Port: ________________________________ Microfilm Publication Number: __________ February 1917 to March 1924 Roll Number: ________________________ Page or Group: _______________________ Line or List: __________________________ List or Manifest of Alien Passengers For the United States ALL ALIENS arriving at a port of continental United States from a foreign port or a port of the insular possessions of the United States, and all aliens arriving at a port of said insular possession from a foreign port, a port of continental United States, S.S._________________ passengers sailing from ___________________, ________________, 19__ 1 2 3 4 5 6 7 8 9 10 11 12 13 Last Permanent Name in Full Age Able to - The name and Final Destination HEAD- Residence TAX complete No. Nationality address of STATUS Calling or Read What on (Country of which Race or People nearest relative Sex (This column Occupation Language City List citizen or subject) City or or friend in for use of Family Name Given Name (or if Country State or Yrs. Mos. Government Read exemption Write Town country whence Town officials only) Married or Single claimed on the alien came what ground) National Archives and Records Administration NARA’s website is www.archives.gov NA Form 14132d (3/05) Immigration Officer at Port of Arrival or a port of another insular possession, in whatsoever class they travel, MUST be fully listed and the master or commanding officer of each vessel carrying such passengers must upon arrival deliver lists thereof to the immigration officer. Arriving at Port of _________________________, _____________________, 19__ 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 nt (See Whether ever before By Whom was in the United States; Purpose of Coming to United Color the Passage Height Place of birth and if so, when and Whether going States of - Paid? ? to join a relative by supported Deformed where? (Whether alien or paid his own or friend; and if Condition or No. passage, whether so, what of health: Crippled. on paid by relative, relative or mental Nature, whether paid by much? List how less if and $50, of sion If Yes - friend, and his and length of destination any other person, Complexion name and physical time, and or by any Yes which so, If charity? corporation, complete whence try cause City or Whether an anarchist Whether a polygamist a Whether Marks of identification or year. one within eported Country Feet society, Hair States Eyes address d town Inches no or municipality, or implied, tolabor inthe United States footnote for full text of this question) this of text full for footnote United States United States Whether coming by reason of any offer, offer, of any reason by coming Whether Whether having a ticket to such final final such to ticket a having Whether government) care for institution or almshouse, or prison in r Whether alien had been previously previously been had alien Whether and treatment of the insane, insane, the of treatment and years Length of time alien alien time of Length solicitation, promise, or agreement, express or or express or agreement, promise, solicitation, pursuits in the United United the in pursuits Year Where? of the United States or all forms of law etc. law of forms all or States United the of temporarily in laboring laboring in temporarily become a citizen of the he came after engaging engaging after he came intends to remain in the the in remain to intends period of of period Whether alien intendsto Whether alien intendsto return to coun to return overthrow by force or violence of the Governme the of violence or force by overthrow Eve Whether a person who believes in or advocates the the advocates or in believes who person a Whether Whether in posses in Whether National Archives and Records Administration NARA’s website is www.archives.gov NA Form 14132d (3/05) .