Formato Iaa v en 2010
-
Upload
briman-merejildo -
Category
Documents
-
view
31 -
download
2
Transcript of Formato Iaa v en 2010
ADDITIONAL INFORMATION OF ARRIVAL
INSTRUCTIONS1. We recommend saving this file as a master copy if you will be submitting information
frequently.a)Click File, then click Save.
b)You will be prompted to give the document a name (as "IAA") and choose a place to save it.
2. Then you can fill out this spreadsheet each time you need to send us this information.
a)Double-clicking on the icon representing the file you saved.b)The file will open and you can simply enter the information required. Once you have
completed filling out the first page, you can move on to the rest of the spreadsheet by using the small gray tabs at the bottom of the window.
3. Once you have completed filling in the required information, save it by clicking File / Save As.
4. You will be prompted to give the document a different name (may be IAA and the name of your vessel) and choose a place to save it.
5. There are several ways to email the form back to us this format.a)You can select File / Send To | Mail Recipient (as attachment), which will open your email
program with the file already attached. You then just put our address, [email protected] in the" To": line, and send it off.
b)Too you can close the spreadsheet program, open your email program, address a new message to [email protected], then attach the file you just saved to the message,
and send it off..
6.This interactive workbook uses excel "Comments", which flags cells that have a comment dialog hidden within the cell. Simply place the cursor over a red flag displayed in the upper right corner of the cell. The dialog box that appears has helpful information
regarding information required in that field.
7. Before emailing the information, please check to ensure all required fields are filled in to avoid any delay in processing and subsequent delay of the vessel.
8. If you are a shipping agent, you can have your clients fill out the spreadsheet on the ship and then have them send you a copy, this may save you from having to forward the
information.
9. If you are submitting for several different vessels frequently, try making a master copy for each ship. After filling out the information the first time, save that file using the ship’s
name. You can then go back into that file for the next required and simply edit the information that has changed.
10. In case that a ship doesn't have the available means to send this information by e-mail, it may send it through by its Shipping Agency, 72 hours before its arrival to the
destination port.
ECUADOR - FUERZA NAVAL DIRECCION NACIONAL DE ESPACIOS ACUATICOS
1. GENERAL INFORMATION OF VESSEL
Vessel Name Call Sign Ship Register (Flag) IMO Number
Type of Ship Year of Build Port of Registry Date of Registry
Lenght overall (LOA) Lenght b. Per (LPP) Lenght (*) Gross Tonnage Net Tonnage Deadweit
Operator / Charterer Breadth Depth Draught
Shipowner Classification Society Security Level
2. INTERNATIONAL SHIP SECURITY CERTIFICATE
Date of Issuance Type of Certificate Vessel Security Plan implemented
Indicate reason if the certificate is Interim Flag Administration or RSO
2.1 SECURITY MARITIME OFFICERS
SSO Name Position or Duties on board Email Address
CSO Name Telephone Number - 24 Hour Email Address
Reporting Party Name Reporting Company / Shipping Agency Telephone Number and/or Email Addres
3. VOYAGE INFORMATION
Destination Port or Place/City Estimated Date & Time of Arrival Estimated Date & Time of Departure
Destination Receiving Facility/Terminal/Anchorage Captain of Port Office/Superintendencia involved
Point of Contact on Port - 24 hour (Shipping Agency and Agent) Telephon Number Email Address
3.1 LAST TEN PORTS
Port Date of Arrival Date of Departure Security Level Additional Measures
3.2 CARGO
General Description of Cargo Cargo Amount Dangerous Cargo on board
Procedures Ship to Ship
ADDITIONAL INFORMATION OF ARRIVAL
Completed the information it may be sent to [email protected]
FORMATO IAA
ECUADOR - FUERZA NAVAL DIRECCION NACIONAL DE ESPACIOS ACUATICOS
Yes No
Approved Interim Final Yes No
Change of Owner/Operator New to/re-entry into service Transfer of vessel's flag
As shown on ships registry.B6:
Name of the person who writes this report, Company or Shipping Agency, Telephone Number and Email Address.B25:
Point of contact on port 24 hour: Shipping Agency and Agent names, Telephone number and Email Address.B32:
Write down a general description of the cargo: example: grains, containers, fuel, etc. "General Cargo" is not accepted.B47:
As shown on ships radio certificate.D6:
Name of the Vessel´s Flag Administration, or the Recognized Security Organization (RSO), representing the Flag Administration that issued the ISSC.
F18:
Specify YES or NO; if the answer is affirmative, detail in the spreadsheet "Measures and Procedures".F35:
Specify YES or NO; if the answer is affirmative, detail in the spreadsheet "Measures and Procedures".G35:
Onwer Arrival Departure1. Name and type of ship 2. Port of arrival / departure 3. Date time of arrival 1.2 OMI Number departure.1.3 Call sign 4. Flag State of ship 5. Name of master 6. Last port call / Next port of call
7. Certificate of registry ( Port date number) 8. Name and contact detail of ship´s agent
9. Gross tonnage 10. Net tonnage
11. Position of the ship in the port (berth or terminal)
12.Brief particulars of voyage (previous/subsequent ports of call; underline where remaining cargo will be discharge
13. Brief description of the cargo.
14. Number of crew (incl. ma15. Number of passangers 16. Remarks
Attached documents (indicate number of copies)
17. Cargo Declaration 18. Ship´s Stores DeclaraYES YES
19. Crew list 20. Passenger List 21. The ship´s requirements in term of waste and residue
YES YES reception fecilities.22. Crew Effects Declaratio 23 Maritime Declaration.
YES of Health. * YES
24. Date and signature by master, authorizad agent or officer.
* A la llegada solamente
OMI GENERAL DECLARATION
Completed the information it may be sent to
ECUADOR - FUERZA NAVAL DIRECCION NACIONAL DE ESPACIOS ACUATICOS
FORMATO OMI FAL 1
.
Page No.Arrival Departure
1. Name and type of ship 2. Port of arrival / departure 3. Date of arrival/deparute1.2 OMI Number1.3 Call sign 4. Flag State of ship 5. Last port of call / Next port call
6.Nomber of persons onboard 7. Period of stay 8. Place of storage
9. Name of article 10.Qua 11. Official usetity
12. Date and signature by master, authorizad agent or officer
.
OMI SHIP´S STORES DECLARATION
Completed the information it may be sent to
[email protected] - FUERZA NAVAL DIRECCION NACIONAL DE ESPACIOS ACUATICOS
FORMATO OMI FAL 3
Page No
1. Name and type of ship 2 Effects ineligible for relief from customs duties1.2 OMI Number and taxes or subject prohibitions or restrictions*1.3 Call sign 3. Flag State of ship
4.No 5 Family name, given names 6. Rank or 7. Signature
rating
08. Date and signature by master, authorizad agent or officer
OMI CREW´S EFFECTS DECLARATION
Completed the information it may be sent to
FORMATO OMI FAL 4
ECUADOR - FUERZA NAVAL DIRECCION NACIONAL DE ESPACIOS ACUATICOS
.
Arrival Departure1. Name and type of ship 2. Port of arrival / departure 3. Date time of arrival 1.2 OMI Number departure.1.3 Call sign
4. Flag State of ship 5. Last port call 6.Nature and No. Of identity document
7. No 8. Family name, 9. Rank 10. Nationality 11. Date and place (seaman´s book and
given names or of birth passport)rating
12. Date and signature by master, authorizad agent or officer
OMI CREW LIST
Completed the information it may be sent to
ECUADOR - FUERZA NAVAL DIRECCION NACIONAL DE ESPACIOS ACUATICOS
FORMATO OMI FAL 5
.
FORMATO OMI FAL 5
ECUADOR - FUERZA NAVAL
DIRECCION NACIONAL DE ESPACIOS ACUATICOS
PASSENGERS LISTFORMATO OMI FAL 6
Arrival Departure Page Number
1.1 Name and type of ship 2. Port of Arrival / Departure 3. Date of Arrival / Departure
1.2 OMI Number
1.3 Call sign 4. Flag State of Ship
5. Full Name and 6.- Nacionality 7. 8. 9. 10. 11. 12.
10. Date and signature by master, authorizad agent or officer.
Completed the information it may be sent to [email protected]
Date and Place of Birth
Type of identity document
Serial Number ID
Port of Embarkation
Port of disembarkation
Pasenger Trafic Yes/No
ECUADOR - FUERZA NAVAL
FORMATO OMI FAL 7
DANGEROUS GOODS MANIFEST
(AS REQUIRED BY SOLAS 74. CHAPTER VII, REGULATIONS 4.5. AND 7-2.2. MARPOL 73/78. ANNEX III. REGULATION 4.3. AND CHAPTER 5.4. PARAGRAPH 5.4.3.1 OF THE IMDG CODE)PAGE NUMBER
1.1. NAME OF SHIP 1.2 IMO NUMBER 1.3 CALL SIGN
1.4 VOYAGE NUMBER 2. FLAG STATE OF SHIP 3. PORT OF LOADING 4. PORT. OF DISCHARGE
5. 6. 7. 8. 9. CLASS 10. ONU No. 11. 12. 13. 14. 15. 16. EmS 17
ADDITIONAL INFORMATION
18.1 NAME OF MASTER 19.1SHIPPING AGENT
18.2 PLACE AND DATE 19.2PLACE AND DATE
SIGNATURE OF MASTER 19.3SIGNATURE OF AGENT
DIRECCION NACIONAL DE ESPACIOS ACUATICOS
BOOKING / REFERENCE NUMBER
MARK & NUMBERS CONTAINER ID NO.(s) VEHICLE REG. NO. (s)
NUMBERS AND KIND OF PACKAGES
PROPER SHIPPING NAME
PACKING GROUP
SUBSIDIARY RISK (s)
FLASHPOINT (in C.c.c.)
MARINE POLLUTANT
MASS (KG) GROSS/NET
STOWAGE POSITION ON BOARD
Completed the information it may be sent to [email protected]
ADDITIONAL MEASURES
Port Additional Measures
PROCEDURES SHIP TO SHIP
Port Security Procedures Ship to Ship
MEASURES AND PROCEDURES
Completed the information it may be sent to [email protected]
ECUADOR - FUERZA NAVAL DIRECCION NACIONAL DE ESPACIOS ACUATICOS
Register only ports in whichsome special or additional measure was adopted.
B5:
Register only the ports in which the protection procedures ship to ship were observed.B21:
Specify the special or additional measures adopted in the indicated port.D5:
Specify the appropriate protection procedures ship to ship in the indicated port.D21:
MARITIME DECLARATION OF HEALTH
To be completed and sumitted yto the competent authorities by the masters of ships arriving from foreing ports.
Submitted at the port of …………………………………………. .. Date …………
Name of ship or inland navigation vessel ……........……....… Registration/IMO No ...................arriving from ……..….…sailing to ...............
(Nationality)(Flag of vessel) ……………………………………. Master’s name ..............................................................................................
Gross tonnage (ship) ……………..
Tonnage (inland navigation vessel) …………………
Valid Sanitation Control Exemption/Control Certificate carried on board? Yes ............ No …......... Issued at ….....…..…… date ……..........
Re-inspection required? Yes ……. No …….
Has ship/vessel visited an affected area identified by the World Health Organization? Yes ..... No …..
Port and date of visit …………………….…….........................
List ports of call from commencement of voyage with dates of departure, or within past thirty days, whichever is shorter:
.........................................................................................................................................................................................................................
Upon request of the competent authority at the port of arrival, list crew members, passengers or other persons who have joined ship/vessel
since international voyage began or within past thirty days, whichever is shorter, including all ports/countries visited in this period (add
additional names to the attached schedule):
(1) Name …………………………………joined from: (1) …………..……....…..(2) …....…..……………....(3) .........................................
(2) Name …………………………………joined from: (1) …………………........(2) ……………….........….(3) .........................................
(3) Name ………………………………….joined from: (1) ……………….....…...(2) ……..….....…...………(3) ........................................
Number of crew members on board …………
Number of passengers on board …………….
HEALTH QUESTIONS Answer Yes or No
1. Has any person died on board during the voyage otherwise than as a result of accident?
If yes, state particulars in attached schedule. Total no. of deaths ..........
2. Is there on board or has there been during the internatinal voyage any case of disease
which you suspect to be of an infectious nature? If yes, state particulars in attached schedule
3. Has the total number of ill passengers during the voyage been greater than normal/expected?
How many ill persons? ..........
4. Is there any ill person on board now ? If yes, state particulars in attached schedule
5. Was a medical practitioner consulted?
If yes, state particulars of medical treatment or advice provided in attached
6. Are you aware of any condition on board which may lead to infection or spread of disease?
If yes, state particulars in attached schedule.
7. Has any sanitary measure (e.g. quarantine, isolation, disinfection or decontamination)
been applied on board?
8. Have any stowaways been found on board? If yes, where did they join the ship (if known)?
9. Is there a sick animal or pet on board?
a)
b)
SIGNED
Master
COUNTERSIGNEDShip's Surgeon
Date :
Note: In the absence of a surgeon, the master should regard the following symptoms as grounds for suspecting the existence of a disease of an infectious nature:
fever, persisting for several days or accompanied by (i) prostration; (ii) decreased consciousness; (iii) glandular swelling;(iv) jaundice; (v) cough or shortness of breath; (vi) unusual bleeding; or (vii) paralysis.
with or without fever: (i) any acute skin rash or eruption; (ii) severe vomiting (other than sea sickness); (iii) severediarrhoea; or (iv) recurrent convulsions.
I hereby declare that the particulars and answers to the questions given in this Declaration of Health (including the schedule) are true and correct to the best of my knowledge and belief.
ECUADOR - FUERZA NAVAL DIRECCION NACIONAL DE ESPACIOS ACUATICOS
Completed the information it may be sent to [email protected]
ATTACHMENT TO MODEL OF MARITIME DECLARATION OF HEALTH
NAME AGE SEX NATIONALITY COMMENTS
State:
CLASS OR RATTING
PORT, DATE JOINED
SHIP/VESSEL
NATURE OF ILLNESS
DATE OF ONSET OF
SYMPTOMS
REPORTED TO A PORT MEDICAL
OFFICER?
DISPOSAL OF CASE
DRUGS, MEDICINES OR OTHER
TREATMENT GIVEN TO PATIENT
1) Whether the person recovered, is still ill, or died; and 2) whether the person is still on board, was evacuated (including the name of the port or airport) or was buried at sea.
ECUADOR - FUERZA NAVAL DIRECCION NACIONAL DE ESPACIOS ACUATICOS
Completed the information it may be sent to [email protected]
N A M E R A N K DATE VACCINATED EXPIRY DATE
OMI CREW VACCINATION LIST
Completed the information it may be sent to
ECUADOR - FUERZA NAVAL DIRECCION NACIONAL DE ESPACIOS ACUATICOS
NIL LIST
1. Name and type of ship DATE:1.2 OMI Number
1.3 Call sign
ARMS AND AMMUNITION
NARCOTICS
PARCEL
PASSENGER
STOWAWAY
THRU CARGO
BIRDS OR ANIMALS
MASTER:
Completed the information it may be sent to [email protected]
ECUADOR - FUERZA NAVAL DIRECCION NACIONAL DE ESPACIOS ACUATICOS
MAIL WAY BILL
1. Name and type of ship DATE:
1.2 OMI Number
1.3 Call sign
ORIGEN DESTINATION
NUMBRES OF SACKS
WEIGHT KILOS
REGISTERED LETTERS & PRINS PARCEL POST EMPTY SACKS
TOTALS
POST OFFICE CLERK RECEIVED ON BOARD AS LISTED
SHIPS MAIL OFFICER
Completed the information it may be sent to [email protected] - FUERZA NAVAL
DIRECCION NACIONAL DE ESPACIOS ACUATICOS