| I, Alexander Ruden Junr?, Consul of the United States of America for the port of Paita, do hereby [certify that the hereafter?] named and described persons have been this day shipped on board within named ship called the Formosa whereof Luther J. Briggs is master, as stated on certificate attached to duplicate articles of said vessel |
| John Smith | U. States | 33 | 5 | 5 | light | light |
| Samuel M. Heartman | U. States | 21 | 5 | 7 | light | light |
| Siles Butler | U. States | 20 | 5 | 6 | light | ? |
| Pablo Sais | Chile | 38 | 5 | 4 | copper | dark |
| Eugenia Asabache | Peru | 18 | 5 | 4 | copper | dark |
| In testimony whereof I have hereunto subscribed my name and affixed the seal of my office at Paita this 14th day of September 1846 [signed] Alexander Ruden, Junr |
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