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| No. | Head-Tax Status | Family Name | Given | Age - Yrs. | Mos. | Sex | Married or Single | Occupation | Read | Write | What Language | Nationality | Race or People | Place of Birth - Country | City/Town | Immigration Visa Number | Issued at | Date | Country | Last permanent residence - City/Town |
| 1 | No Tax | Tuning | Anne | 35 | 7 | F | M | housewife | Yes | Yes | English | Nflder | English | Nfld | Salmonier | 1357 | St. John's, Nf | 23:3:28 | U.S.A. | Nantucket |
| 2 | No Tax | Verge | Underwood | 21 | 6 | M | S | Carpenter | Yes | Yes | English | Nflder | English | Nfld | Old Bonaventure | Ret'd. temp. visit | U.S.A. | Medford | ||
| 3 | No Tax | Verge | Ethel | 17 | 8 | F | S | Domestic | Yes | Yes | English | Nflder | English | Nfld | -do- | 1397 | St. John's, Nf | 30:3:28 | Nfld | Old Bonaventure |
| 4 | No Tax | Vivian | Annie | 24 | 8 | F | M | housewife | Yes | Yes | English | Nflder | English | Nfld | Jamestown | 1368 | St. John's, Nf | 27:3:28 | Nfld | Jamestown |
| 5 | No Tax | Warford | Annie | 25 | 6 | F | S | Cook | Yes | Yes | English | Nflder | English | Nfld | Port de Grave | Ret'd. temp. visit | U.S.A. | Boston | ||
| 6 | No Tax | Warford | Rebecca | 19 | 6 | F | S | - | Yes | Yes | English | Nflder | English | Nfld | Ship Cove | 1330 | St. John's, Nf | 16:3:28 | Nfld | Ship Cove |
| 7 | No Tax | Whelan | Robert | 49 | - | M | M | Carpenter | Yes | Yes | English | Nflder | English | Nfld | Broad Cove | Ret'd. temp. visit | U.S.A. | Chelsea | ||
| 8 | No Tax | Whiffen | Mary | 25 | 6 | F | S | - | Yes | Yes | English | Nflder | English | Nfld | So. Harbour | 1340 | St. John's, Nf | 22:3:28 | Nfld | St. John |
| 9 | No Tax | Yetman | Gladys | 24 | - | F | S | Tailoress | Yes | Yes | English | Nflder | English | Nfld | Harbour Grace | 1401 | St. John's, Nf | 30:3:28 | Nfld | Harbour Grace |
| Verge = brothers Warford = sisters |
Column heading abbreviations:
| |||||||||||||||||||||||||
| No. | Name and complete address of nearest relative or friend in country whence alien came | Final Destination - State | City/Town | Has ticket to final destination | Who paid passage | In possesion of money | Ever in US Before - Yes/No | Year(s) | Where | Joining relative/friend and who/address | A | B | C | D | E | F | G | H | I | J | K | L | M | N | O |
| 1 | Brother Mr. J. Gregory, Salmonier, NF | Mass | Nantucket | No | Husband | Yes | Yes | 1927 | Nantucket | Husband Felix Tuning, 23 Pleasant St. Nantucket | No | - | - | - | - | - | - | - | - | - | - | 5 7 | Med | Brn | Brn |
| 2 | Father Mr. P. Verge, Old Bonaven., NF | Mass | Medford | No | Self | Yes | Yes | 1927 | Medford | Uncle F. King, 125 Surrey St., Medford | No | Reside | Yes | No | No | No | No | No | No | Good | - | 5 5 | Med | Brn | Gray |
| 3 | Mother Mrs. S. Verge, Old Bonaven., NF | Mass | Boston | Yes | Brother | Yes | No | - | Sister F. Hewitt, 24 Puttman Av, Boston | No | Reside | Yes | No | No | No | No | No | No | Good | - | 5 2 | Fair | Brn | Blue | |
| 4 | Father Mr. H.J.Pike, Jamestown, NF | Mass | S. Boston | Yes | Husband | Yes | Yes | 1927 | Boston | Hustand Robert Vivian, 11 Peter St., S. Boston | No | Reside | Yes | No | No | No | No | No | No | Good | - | 5 8.5 | Fair | Brn | Blue |
| 5 | Father Mr. J. Warford, Port de Grave, NF | Mass | Boston | Yes | Self | Yes | Yes | 1927 | Boston | Cousin, R. Morgan, 224 Cheanut St., Chelsea | No | Reside | Yes | No | No | No | No | No | No | Good | - | 5 2 | Med | Brn | Gray |
| 6 | entry illegible | Mass | Boston | Yes | Sister | Yes | No | - | Sister A. Warford, 148 Mt. Vernon St., Boston | No | Reside | Yes | No | No | No | No | No | No | Good | - | 5 3.5 | Med | Brn | Blue | |
| 7 | Wife Mrs. Wheland, Broad Cove, NF | Mass | Chelsea | No | Self | Yes | Yes | 1927 | Chelsea | Dauaghter Caroline Whelan, 134 Congress Av., Chelsea | No | Reside | Yes | No | No | No | No | No | No | Good | - | 5 8 | Fair | Fair | Blue |
| 8 | Father, Mr. John Whiffen, St. John's, NF | Mass | Roxbury | No | Father | Yes | No | - | Brother Paul Whiffen, 122 London St., E. Boston | No | Reside | Yes | No | No | No | No | No | No | Good | - | 5 6 | Med | Brn | Brn | |
| 9 | Sister Mrs. J. C. Noel, Harbour Grace, NF | Mass | Dorchester | No | Self | Yes | Yes | 1927 | Dorchester | Sister Sadie Yetman, 104 Millet St., Dorchester | No | Reside | Yes | No | No | No | No | No | No | Good | - | 5 6 | Med | Brn | Blue |
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