IMO CREW'S EFFECTS DECLARATION
(IMO FAL Form 4)
|
|
Page Number |
|||
1.1 Name of ship CITY OF ST. PETERSBURG
|
1.2 IMO number 9473456
|
||||
1.3 Call sign 3FIM5
|
1.4 Voyage number 77 |
||||
2. Flag State of ship Panama
|
|
||||
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 |
|
1 |
Górtowski Paweł |
captain |
|
|
|
2 |
Antosik Katarzyna |
|
|
|
|
3 |
Beling Błażej |
|
|
|
|
4 |
Boguszewska Honorata |
|
|
|
|
5 |
Ciszak Rafał |
|
|
|
|
6 |
Ciszkiewicz Grzegorz |
|
|
|
|
7 |
Dobraszczyk Wojciech |
|
|
|
|
8 |
Jankowski Piotr |
|
|
|
|
9 |
Kamionka Celina |
|
|
|
|
10 |
Kołakowska Martyna |
|
|
|
|
11 |
Mazurkiewicz Karolina |
|
|
|
|
12 |
Miroshnichenko Kostyantyn |
|
|
|
|
13 |
Oponowicz Arkadiusz |
|
|
|
|
14 |
Paćwkowski Tomasz |
|
|
|
|
15 |
Piotrowicz Szymon |
|
|
|
|
16 |
Piskuła Krzysztof |
|
|
|
|
17 |
Ptaszyński Dawid |
|
|
|
|
8. Date and signature by master, authorized agent or officer
|
|||||
e.g., wines, spirits, cigarettes, tobacco, etc.