Ship's Name:_____________________________ Flag:_________________ Year:____________

Department	QSM System Elements(to be audited)	Ref. to Previous Findings/Comments	Auditor	Date to be arranged

DPA/M.R.: ______________________________

Note: To be completed yearly and filed in office's file.

To retain for 3 years.

Issue date: 03.11.2003/Rev. 00 PBO-G∗09-F02 Page: 1/1

INTERNAL AUDIT PLAN (VESSEL)

QSMS PBO-G∗09-F02 Rev. No.00

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