Form of clearance.
The form of a clearance, to be granted to a ship or vessel on her departure to a foreign port or place, shall be as follows:
District of , ss,
Port of
These are to certify all whom it doth concern, that , master or commander of the , burden tons, or thereabouts, mounted with guns, navigated with men, built, and bound for , having on board , hath here entered and cleared his said vessel according to law. Given under our hands and seals, at the custom-house of , this day of , one thousand , and in the year of the Independence of the United States of America. (R. S., 4201; Apr. 29, 1902.)