Click here to download a PDF version. Vessel Information Vessel NameLloyds No ETAETA Date Preferred Berth ETDETD Date Alternate Berth GRTLOABeam FlagArrival DraftDeparture Draft DATE AT SEA BUOY estimated Time Cargo Information Type of CargoQuantity Custom’s InspectionsCoast Guard Inspections Vessel will: Load CheckDischarge Check StevedoreTerminal Operator ReceivingShipping Company Last PortNext Port Will vessel receive (check one): StoresBunker Will vessel request water (check one): YesNo Will vessel change crew (check one): YesNo Agent Information CompanyContact NamePhone 24/7 Number FaxAlternate NumberEmail Billing Information (fill in the responsible party) 1) Wharfage2) Dockage3) Linehandling 4) Water5) Harbor Master 6) StorageExpected Time PeriodType Location 7) Security Fees
