S/No.	Topic Relevant to QSMS	Description of Discrepancies/ Changes/Shortcomings of QSMS			Suggestion
	Suggested by: (Name/Rank)			Signature/Date
1
2
3
4

Note: To be completed every voyage and filed in both office's file and ship's file.

To retain for 5 years.

Issue date: 03.11.2003/Rev.00 PBO-G∗01-F04 Page: 1/1

SUGGESTION TO THE COMPANY QSMS

QSMS PBO-G∗01-F04 Rev. No.00

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