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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□
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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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