1、1. Name and description of ship 4. Nationality of ship 5. Name of master 7. Certificate of registry (Port; date; number) 9. Gross tonnage 10. Net tonnage 1 1. Position of the ship in the port (berth or station) u .- .+ c L I- .- E r“ 44 L .- - m c O m al c O c O m u m LL c O C O t al c O o O .- c E
2、c - c .- c c .- - .- .- c r Arrival Departure 2. Port of arrivalldeparture 3. Date -time of arrivalldeparture 6. Port arrived fromiport of destination 8. Name and address of ships agent 13. Brief description of the cargo 16. Remarks 19. Crew List Attached documents (indicate number of copies) 17. Ca
3、rgo Declaration 18. Ships Stores Declaration 20. Passenger List 21, Date and signature by master, authorized agent or officer 22. Crews Effects Declaration“ 23. Maritime Declaration of Health For official use IMO FAL Form 1 Only on arrival This form is accepted in the following countries, either as
4、an IMO form or as a national form based on the same layout (in some cases subject to minor modifications or conditions to be observed by the declarant). * ARGENTINA AUSTRALIA BELGIUM BRAZIL CANADA CHILE CUBA CYPRUS ECUADOR FINLAND GERMANY HUNGARY INDONESIA IRELAND LIBERIA MEXICO NETHERLANDS NEW ZEAL
5、AND NORWAY PERU POLAND RUSSIAN FEDERATION SEYCHELLES SINGAPORE SWEDEN THAILAND UNITED KINGDOM UNITED STATES YUGOSLAVIA This form is also accepted in Hong Kong (Associate Member of IMO). * See supplement relating to the Annex to the Convention on Facilitation of International Maritime Traffic, 1965, as amended, for further details (available from IMO, 4 Albert Embankment, London SEI 7SR. sales number IMO-350Ei. For official use Copyright O IMO 1993 Sales number: IMO-371 E
