Form No.39
Customs Series Form No.39
[See Notification No. 107-Cus., dated 9.9.1950]
CUSTOM HOUSE,
Dated...... 19....
Certified that my baggage was shipped at a Customs port, namely............................
and that the same was
not transhipped from any other vessel from a Foreign port without payment
of duty.
(Signature)
Passenger per. S.S."................."
Address ....................