Form No. Two.

COMMONWEALTH OF MASSACHUSETTS.

To City (or Town) of.

For support of.

Dr.

A State Pauper too ill to be removed to a State Almshouse,

We hereby certify that the above bill is correct and statement true, to

We hereby certify that the above bill is correct and statement true, to

TEMPORARY AID.

The following forms are for use under the Act of 1877, granting temporary aid to persons not sick. It must be remembered that the law grants this aid for four weeks only The notice is not renewable. Further aid is given by the State only in its State almshouse.

188

To the Superintendent of Out-door Poor, 9 State House, Boston.

We are now furnishing aid to the family of

and shall expect re-imbursement, in accordance with the provisions of chap. 183 of the Acts of the year 1877.

For Overseers of the Poor.

Residence, where within the town.

Number of persons in family.

Amount per week.

Probable continuance.

Ought the person to be removed from the State?

Facts relative to settlement.

NOTE. This form of notice must never be used for a sick person.

I hereby certify that the above bill is correct, to my best knowledge and belief.

For the Overseers of the Poor.

NOTE. - This form of bill must never be used for a sick person.

FORMS FOR THE OUT-DOOR POOR,

WHEN ADMITTED TO STATE ALMSHOUSE, ETC.

[THE following is the form used by the Mayors of cities and the Overseers of the Poor of towns for the commitment of State paupers to the State Almshouse at Tewksbury. The same form will answer for the commitment of foundlings and destitute children to the Massachusetts Infant Asylum, by slightly changing the phraseology, e.g.: "The Directors of the Massachusetts Infant Asylum will," etc., and by striking out the first, second, and third in the series of questions.

It is well to remember that the power of commitment to Tewksbury is vested solely in the above-named officers. This Board can transfer thither inmates of certain institutions; but it has no direct power to commit from the cities and towns.]

.188

The Superintendent of State Almshouse, Tewksbury, will please admit the following person from

NAME.

AGE.

BIRTHPLACE.

REMARKS.

Overseer of

General Remarks to contain Answers to the following Questions:

4. Names of parents?

5.

Mother's maiden name?

6. Birthplace of parents?

7. Present residence of parents?

8. Former residence of parents?

9. Names and place of residence formerly, and now, of grandparents? 10. Number of years that the individual, his parents, or grandparents, have resided in the town or city from which sent?

11. Number of years they have paid taxes in said city or town?

12.

If in the military service of the United States during the civil war, in what regiment and company did he serve? 13. If in the navy, when and where did he enlist?

N.B.Overseers are reminded that under the Public Statutes, chap. 86, sects. 24, 25, and chap. 162 of the Acts of 1865, it is forbidden to send to either of the State Almhouses "any person who by reason of insanity would be dangerous if at large," or "any person infected with small-pox or other disease dangerous to the public health, or any other sick person whose health would be endangered by removal."

ACT TO REGULATE IMMIGRATION.

[THE act recited below went into effect Aug. 3, 1882, since which time the Governor has designated the State Board of Health, Lunacy, and Charity as the board with which the Secretary of the Treasury may enter into contract to take charge of the local affairs of immigration in the ports of Massachusetts, and for other purposes mentioned in the act.]

AN ACT TO REGULATE IMMIGRATION.

Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled, That there shall be levied, collected, and paid a duty of fifty cents for each and every passenger not a citizen of the United States who shall come by steam or sail vessel from a foreign port to any port within the United States. The said duty shall be paid to the collector of customs of the port to which such passenger shall come, or if there be no collector at such port, then to the collector of customs nearest thereto, by the master, owner, agent, or consignee of every such vessel, within twenty-four hours after the entry thereof into such port. The money thus collected shall be paid into the United States Treasury, and shall constitute a fund to be called the immigrant fund, and shall be used, under the direction of the Secretary of the Treasury, to defray the expense of regulating immigration under this act, and for the care of immigrants arriving in the United States, for the relief of such as are in distress, and for the general purposes and expenses of carrying this act into effect. The duty imposed by this section shall be a lien upon the vessels which shall bring such passengers into the United States, and shall be a debt in favor of the United States against the owner or owners of such vessels; and the payment of such duty may be enforced by any legal or equitable remedy: provided, that no greater sum shall be expended for the purposes hereinbefore mentioned at any port than shall have been collected at such port.

SECT. 2. That the Secretary of the Treasury is hereby charged with the duty of executing the provisions of this act and with supervision over the business of immigration to the United States,