Ship registration

Name of vessel*

Port or registry*

Call sign*

IMO-nr*

Nationality*

GT*

NRT*

DWT*

Length (m)*

Bredth*

Max Draught*

Name of the Captain*

Name*

Postal address*

VAT nr*

Phone number*

Date of arrival*

Date of departure*

Dangerrous cargo on board – IMDG code

Score by ESI

Fuel

Stars by ESI

Last port*

Arrives via*

Carriyng cargo from foreign countries* Yes No

Arrives bearth

Departure to

Departure via

Will the vessel depart with not unloaded cargo from foreign countries to another Swedish port* Yes No

Departure bearth

Shipping company/Client*

VAT nr

Fresh water Sludge Garbage

I hereby acknowledge receipt of valid harbour regulations for the port of Piteå and undertake to pay current harbour dues according to established rates. I guarantee that the information given above is correct.

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Fartygsanmälan

Vessel Information

Agent

Arrival info

Departure info

Payment responsibility for vessel dues

Goods declaration

Arriving goods

Departing goods

Service