APPLICATION FOR CERTIFICATE
FOR REDUCED RAILWAY RATES TO WESTERN CANADA

Name of head of family........................................Geo. Rasmussen.......................................Age........................................

Names of other members of family for whom certificates are required.
 (Mention those only who are going at this time with you)

Mrs. ........................................Wife........................................

Name of party must be distinctly specified when travelling in car with stock.

At present living in section........................................
Township........................................Oconomowoc........................................County........................................State..........Utah..........
Post Office Address........Parowan................................
Destination in Canada........................................
Country of Birth........................................
Value of effects........................................

Kindly return this to me at once, stating when you wish to leave for Western Canada, and being satisfied that you are likely to become a bona fide settler, and entitled to the low passenger and freight rates, a certificate will be sent to you which will secure you this.