APPENDIX 1

IMO GENERAL DECLARATION

Departure

X

Arrival

1.1

Name and type of ship

CITY OF ST. PETERSBURG / Vehicles Carrier

2. Port of arrival/departure

3. Date - time of

1.2

IMO number 9473456

arrival/departure

1.3

Call sign 3FIM5

Saint Petersburg, (Russia)

02.04.2012

4.

Flag State of ship Panama

5. Name of master P.Górtowski

6.

Last port of call/Next port of call Hanko/St. Petersburg

7.

Certificate of registry (Port; date; number)

8.

Name and contact details of ship’s agent Dynamic Tip Suite 300, Fidelity Life Building, 1112, Pender Street W, Vancouver BC V6E 2S1, Canada.

Panama

9.

Gross tonnage

10. Net tonnage

21143

20000

11. Position of the ship in the port (berth or station)

station

11. Brief particulars of voyage (previous and subsequent ports of call; underline where remaining cargo will be discharged)

2012 March 31st, 04:00:07 UTC New Castle,uk

2012 March 29th, 02:00:21 UTC Le Havre

2012 March 26th, 17:00:14 UTC Whitehill

2012 March 25th, 06:00:41 UTC Emden

2012 March 21st, 06:00:29 UTC St Petersburg

2012 March 19th, 04:00:25 UTC Gdansk

2012 March 15th, 22:00:23 UTC New Castle,uk

2012 March 12th, 18:00:51 UTC Hanko

11. Brief description of the cargo

2012 March 31st, 04:00:07 UTC New Castle,uk

2012 March 29th, 02:00:21 UTC Le Havre

2012 March 26th, 17:00:14 UTC Whitehill

2012 March 25th, 06:00:41 UTC Emden

2012 March 21st, 06:00:29 UTC St Petersburg

2012 March 19th, 04:00:25 UTC Gdansk

2012 March 15th, 22:00:23 UTC New Castle,uk

2012 March 12th, 18:00:51 UTC Hanko

14. Number of crew (incl.	15. Number of passengers	16. Remarks
master)
17	16

Attached documents (indicate number of copies)

17. Cargo Declaration 18. Ship’s Stores

Declaration

19.	Crew List	20. Passenger List		21. The ship’s requirements in terms of waste and residue
	17			reception facilities
22.	Crew’s Effects	23. Maritime Declaration
Declaration*			of Health*

24. Date and signature by master, authorized agent or officer For official use

PDF to Word