District of the City of New York
Port of New York

CUSTOMS LIST OF PASSENGERS

I, Henry Walker, Master of the S. S. Campania do solemnly sincerely and truly swear that the following List or Manifest subscribed by me, and now delivered by me to the Collector of Customs of the District of the City of New York, is a full and perfect list of all the passengers taken on board said vessel at Liverpool and Queenstown from which port or ports the said vessel has now arrived; and that on said list is truly designated the age, sex, calling or occupation, the port of embarkation, the number of pieces of baggage, of all the passengers, the date and cause of death of any such passengers who may have died on the voyage, and also a statement, so far as it can be ascertained, with reference to the intention of each immigrant passenger as to a protracted sojourn in this country, and also in regard to Cabin passengers, the country of which they are citizens, and of passengers other than cabin passengers, their native country, their intended destination or location in the United States, and whether they are citizens of the United States, or not, and the location of the compartment or space occupied by each, as required by the Passenger Act of 1882 and the Regulations of the Secretary of the Treasury. So help me God.

Sworn to before me this 25 day of May 1895.