Prior Notification Report Form

* - denotes a required field.

*Vessel: *IMO Number:
*MMSI Number: *Call Sign:
*Last Port of Call: *UNLOCODE:
*Next Port of Call: *UNLOCODE:
*ETA:
(dd/mm/yyyy)
 *Time: (hh:mm)
*ETD:
(dd/mm/yyyy)
 *Time: (hh:mm)
*Passengers: *Crew:

The following shall be completed for vessels carrying dangerous or polluting goods (DPG):

INF Class:
Cargo Manifest Details: (Options 1-4)

Additional Details as Required:

Addtional Information For Port Requirements

Arrival Draught Fwd: (m) Aft: (m)
Cargo Type:
Cargo On-Board: (tonnes)
Ballast On-Board: (tonnes)
Deficiencies:

Details:

*Agent's Name / Company:
*Date:
(dd/mm/yyyy)