IMO FORM 375E-1993 IMO Crew List.pdf

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1、I Page NO. IMO CREW LIST . U .- Y- 9- to I- .- E f I L .- - m C O m W C O C O I m I o m U C O C O C W C O o O .- c E c - - .- .- - .- .- w r IMO FAL Form 5 . 1. Name of ship Q. Nationality of ship . . 7. No. 8. Family name, given names . . . . . . 12. Date and signature by master, authorized agent o

2、r officer . . 9. Rank or rating . . . . . . . . . . 2. Port of arrival/departure of identitv docu- . . . . . . 10. Nationality .,. . . . . ment (seamans passport) . .I .l. . . .I ./ I This form is accepted in the following countries, either as an IMO form or as a national form based on the same layo

3、ut (in some cases subject to minor modifications or conditions to be observed by the declarant). * ARGENTINA AUSTRALIA BELGIUM BRAZIL CANADA CHILE CUBA ECUADOR FRANCE GERMANY GREECE HUNGARY IRELAND ITALY LIBERIA MEXICO NETHERLANDS NEW ZEALAND NORWAY PERU POLAND RUSSIAN FEDERATION SEYCHELLES SPAIN SW

4、EDEN UNITED KINGDOM UNITED STATES YUGOSLAVIA This form is also accepted in Hong Kong (Associate Member of IMO). * See supplement relating to the Annex to the Convention on Facilitation of International Maritime Traffic, 1965, as amended, for further details (available from IMO, 4 Albert Embankment, London SEI 7%. sales number IMO-350E). For official use Copyright O IMO 1993 Sales number: IMO-375E