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(FORM. NO. 140.)
CONSULAR CERTIFICATE.

I, the undersigned,

Consul-General of the United Stats, do hereby certify that, on this 27th day of July, A. D. 1901 the invoice described in the indorsement hereof was produced to me by the signer of the annexed declaration.
I do further certify that I am satisfied that the person making the declaration hereto annexed is the person he represents himself to be, and that the actual market value or wholesale price of the merchandise described in the said invoice in the principal markets of the country at the time of exportation is correct and true, excepting as noted by me upon said invoice, or respecting which I shall make special communication to the proper authorities. I further certify

Witness my hand and seal of office the day and year aforesaid.
Received Marks 10.60, equal to $2.50, U. S. gold.
Frank H. Mason
United States Consul General.

(FORM. NO. 138.)
Declaration of Purchaser or Seller or Duly Authorized Agent of Either.

I, the undersigned, do solemnly and truly declare that I am the Seller of the merchandise in the within invoice mentioned and described; that the said invoice is, in all respects, correct and true, and was made at Berlin, Germany, whence said merchandise is to be exported to the United States, that said invoice contains a true and full statement of the time when, the place where, and the person from whom the same was purchased, and the actual cost thereof, price actually paid or to be paid therefor, and all charges thereon; that no discounts, bounties, or drawbacks are contained in said invoice but such as have been actually allowed thereon; that no different invoice of the merchandise mentioned in said invoice has been or will be furnished to any one, and that the currency in which said invoice is made out is that which was actually paid or is to be paid for said merchandise. I further declare

I further declare that it is intended to make entry of said merchandise at the port of Detroit, in the United States of America.
Dated at Berlin, Germany, this 
27th day of July, 1901
R. Wagner

22 Aug 01
QUADRUPLICATE
PURCHASED BY IMPORTER.

Invoice No. 3506 Issued in [[strikethrough]] TRIPLICATE [[/strikethrough]] QUADRUPLICATE

Consulate General of the United States
AT Berlin, Germany.
Date: July 27th, 1901
Seller: R. Wagner, Berlin, Dessauerstr.
Purchaser: Mr. Charles L. Freer 
33. Ferry Avenue Detroit Mich.
Name of vessel:
Port of shipment: Bremerhaven
Port of arrival: Baltimore
Port of entry: in bond to Detroit
Value: 828 Marks
Contents: Pottery Vases, bowls and jars, one Chinese picture

Duty &c 117.14
Char L Freer

CUSTOM-HOUSE INDORSEMENT.*
No.
Importer:
Vessel:
From:
Arrived:

Kind of Entry:

Marks, Quantity, and Contents:

*Consular officers will leave all of above indorsement blank. It is to be filled in only at the customhouse at the port of entry.