| Arrival: | 14 Aug 1916???? |
| Vessel: | Sicilian |
| Port of Arrival: | Quebec |
| Port of Departure: | Liverpool, England |
This sheet is to be used for "Steerage" passengers only
NB - The table below has been rotated, so for columns read rows.
| No. of Passengers | 1 | 5 | 6 | 7 | 8 | 9 | |
| No. of S.S. Contract Ticket | 2 | 1263 | |||||
| Amount of Cash in $ | 3 | 30.00 | |||||
| Name in Full | 4 | Freestone Annie | Freestone Martha | Freestone Thomas | Freestone Dora | Freestone John | |
| Age of Adults | Male | 5 | |||||
| Female | 6 | 40 | 17 | ||||
| Under Under 11 Years | Male | 7 | 13 | 4 | |||
| Female | 8 | 6 | |||||
| Married, Single or Widowed | 9 | M | S | S | S | S | |
| Have you ever been in Canada before? | 10 | No | No | No | No | No | |
| If So | When | 11 | |||||
| Where | 12 | ||||||
| How Long | 13 | ||||||
| Do You Intend to Permanently Reside in Canada? | 14 | Yes | Yes | Yes | Yes | Yes | |
| Are You Able to Read? | 15 | Yes | Yes | Yes | Yes | Yes | |
| Are You Able to Write? | 16 | Yes | Yes | Yes | Yes | Yes | |
| Country of Birth | 17 | England | England | England | England | England | |
| No. of Passengers | 18 | 5 | 6 | 7 | 8 | 9 | |
| Race of People | 19 | English | English | English | English | English | |
| Destination | Post Office | 21 | W'peg | W'peg | W'peg | W'peg | W'peg |
| Province | 21 | Man | Man | Man | Man | Man | |
| What was your occupation in country from which you came? | 22 | Housewife | Shop Asst | ||||
| What is your intended occupation in Canada? | 23 | Join Son | Shop Asst | ||||
| Have you ever worked as farmer, farm labourer, gardener, stableman, carter, Ry. surfaceman, navvy or miner? | 24 | ||||||
| If So | Which | 25 | |||||
| How Long | 26 | ||||||
| When | 27 | ||||||
| Religious Denomination | 28 | C.E. | C.E. | C.E. | C.E. | C.E. | |
| Travelled Inland On | 29 | C.P.R. | C.P.R. | C.P.R. | C.P.R. | C.P.R. | |
| Initials of Civil Examiner | 30 | ||||||
| No. of Passengers | 31 | 5 | 6 | 7 | 8 | 9 | |
NB - Ancestry give the date of arrival as 14 August 1916, but this can not be correct as the ship sailed on the same date!