A link to the Portable Document Format (PDF) of this form is provided below. The content of the form is duplicated in HTML following the PDF link.
Must be submitted 96 hours prior to arrival. Please submit in person, by fax or e-mail.
- Cruise ship name and call sign
- Agent Contact Person
- Telephone no.
- Fax no.
- Are all ship certificates valid?
- No - If no, include in comments.
- Port and country of departure
- Last four ports visited prior to port of departure
- Date and time of arrival
- Date and time of departure
Crew and Passenger Information
- Number of passengers
- Passenger list attached?
- Number of crew
- Crew list attached?
- Number of repatriating crew
- List attached?
- Date modified: