| Name of
ship:
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| IMO
number/call sign:
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| Flag
State:
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| Gross
tonnage:
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| Deadweight (where appropriate):
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| Date of
report:
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| Report
by:
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| Classification Society:
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| Recognized Organization involved:
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| Did you
receive the notification of detention? (tick the box if the answer is
'yes
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| Action
taken
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a) Deficiencies
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b) Cause
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c) Action taken
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| Additional Information:
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