IMO CREW'S EFFECTS DECLARATION
(IMO FAL Form 4)
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Page Number |
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1.1 Name of ship Malmo |
1.2 IMO number 8116738 |
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1.3 Call sign 4LVR |
1.4 Voyage number 112432 |
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2. Flag State of ship Tanzania |
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3. No. |
4. Family name, given names |
5. Rank or rating |
6. Effects ineligible for relief from customs duties and taxes or subject to prohibitions or restrictions* |
7. Signature |
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1 |
Damian Rolewski |
Master |
[Wine - 5l, Whiskey -1l] |
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2 |
Krzysztof Ignaczak |
1st mate |
- |
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3 |
John Brown |
2nd mate |
- |
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4 |
Jon Snow |
3rd mate |
- |
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5 |
Robb Stark |
Bosun |
- |
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6 |
Tytus Bomba |
Cook |
[Cigaretes - 10, Beer 2l] |
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7 |
Michał Głuś |
O/S |
[Cigaretes-5,Vodka 0,5l] |
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8 |
Kamil Zdun |
O/S |
[Vodka - 1l] |
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9 |
Radosław Rumian |
O/S |
- |
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10 |
Bogusław Łęcina |
Cadet |
- |
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8. Date and signature by master, authorized agent or officer 10.05.2014 Rolewski Damian
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* e.g., wines, spirits, cigarettes, tobacco, etc.