| 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 |
| William Washington | U. States | 19 | 5 | 5 | light | light | The above named person has been [words lost in fold] since departure [of the ship?] from the United States on the above terms stated in the certificate attached to duplicate articles |
| Thomas Bennett | Denmark | 30 | 5 | 7 | light | light |
| William Dyer | U. States | 28 | 5 | 6 | light | light |
| Antonio Perez | Chile | 13 | 5 | 2 | dark | dark |
| John DeWitt | U. States | 27 | 5 | 6 | dark | dark |
| John Miller | Hamburg | 29 | 5 | 8 | light | light |
| In testimony whereof I have hereunto subscribed my name and affixed the seal of my office at Paita this 8th day of January 1846 [signed] Alexander Ruden, Junr |
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