Link
Link
Link
v essel 010133
Jnker Tanker
_ 010134
Surveyors 010135
Others 010136
(To Specify) (To Specify)
Acknowledged by:
S!gn8ture 0,fM~ter / Chief E Full Name in Block Letter
,.1
- ... '.Or.
':".
I ".,
\ nl' ;l.,
.. ,', ~,,: ::'J' ;,,#Pj.4. ll "ame pI Block Letter
N
~HOnti\ .,;r-' .""~ Vessel's Stamp Bunker Tanker's Stamp
~ '--' ,.",._~;.p
REMARKS: ""
Was note of Protest issued? ~ / NO
BSI02R2