ANNEX
INFORMATION TO BE NOTIFIED BEFORE ENTRY INTO THE PORT OF
(Port of destination as referred to in Article 6 of...
1. Name, call sign and, where appropriate, IMO identification number of...
2. Flag State:
3. Estimated time of arrival (ETA):
4. Estimated time of departure (ETD):
5. Previous port call:
6. Next port of call:
7. Last port and date when ship-generated waste was delivered:
8. Are you delivering (tick appropriate box):
9. Type and amount of waste and residues to be delivered...
Notes
1. This information may be used for port State control and...
2. Member States will determine which bodies will receive copies of...
3. This form is to be completed unless the ship is...
I confirm that:
the above details are accurate and correct, and there is...
Date …
Time …
Signature …