Icelandic Coast Guard / Maritime Traffic Service MTS / ICG A d d r e s s e s Telefax transmissions are not accepted. Tel:354 545 2100 Urgency tel 354 511 3333 MMSI002516200 Inmarsat C:581425101519 E-mailsar@lhg.is Version JUNE 2005 Mandatory All vessels report to Iceland 24 hours before arrival. 3 sheets, Data sheet, Crew list, Passenger list. See notes. Date of report: Time: Reports may be sent from: Vessel, Owner, (CSO) or Agent, by E-mail or Inmarsat C as text. 1. Vessel Name: 2. Registration: 3. IMO number: 4. Call Sign: 5. Nationality: 6. Vessel Type: 7. Mobile Telephone: 8. Telefax: 9. E-mail: 10. Inmarsat C: 11. Other satellite comms numbers: 12. Registered owner: 13. Owner's Email: 14. Owner's Address: 15. Owner's telephone: 16. Manager: 17. Manager's E-mail: 18. Manager's Address: 19. Manager's telephone: 20. Gross tonnage: 21. Net tonnage: 22. Length over all: 23. Draft: 24. Fuel onboard: 25. Class of vessel: 26. Present Position, Lat / Long: 27. EST Entry position IEEZ (200 nm): Time of entry HH:MM : 28. Crew total number: 29. Passengers Total number: 30. Agent in Iceland: 31. Pilot requested (if known): 32. Last Port of Call before Iceland: 33. First port of call in Iceland: 34. ETA first port Iceland, date and time of arrival: 35. Other port calls in Iceland (report all changes of scheduled portcalls): 36. Estimated route to destination in Iceland: 37. Reason for port call, brief description: 38. Departure port Iceland: 39. ETD last port Iceland 40. Next destination after Iceland 41. Weapons and ammunitions: 42. Live animals onboard: 43. International Ship Security Certificate (ISSC) (cargo vessels) issued by: 44. ISSC Certificate number (cargo vessels) 45. ISSC Certificate date (cargo vessels). 46: Infectious Diseases Yes / No 47. 10 last ports: Port name: 48. Port facility number: 49. Date: 50. Security level 51. Special or additional security measures in 10 last previous ports 52. Any ship to ship interface since last port 53. Date and time 54. Security level 55. Special or additional security measures during ship to ship interface: 56. Amplifying information / remarks: IMDG cargo 57. Technical name 58. UN numbers 59. IMO numbers 60. IMO hazard classes 61. Quantities 62. Location onboard 63. Identification marks. 64. IMDG Address 1. 65. IMDG Address 2. 66. IMDG Address 3. Confirmation that a list of appropriate loading plan giving details of dangerous or polluting goods and of their location on the vessel is correct, captain name, date and time:(sign Report quantities of oil products on board, type, bunkering place, bunkering date, technical names. 67. Total oil qty: 68. Oil type 69. Bunkering place 70. Bunkering date Total quantity liters: Ship-Shore traffic information (if known) Visitors to board the vessel: 71. Name 72. Nationality 73. Company/position 74. Passport ID 75. Received. Supplies to the vessel 76. Description 77. Sender 78. Transport company & driver 79. Passport ID 80. Received(sign): Persons from Port Facility to board the vessel: 81. Name 82. Nationality 83. Position 84. ID 85. Received 86. Master / SSO name: 87. Company Security officer / CSO name: 88. Current Ship security level:(1 normal) Note 1. This is an All vessels report in regards for the following requirements: ISPS, IMDG,Immigrations, Customs, harbours, Maritime Administration (IMA), Directorate of Fishing and the Ministry for the Environment. Crew and passengers sheets are included. Note 2. Vessels with IMDG cargo shall report when departing loading port. Confirm departure time atleast 6 hours in advance. Vessels shall report immediately all changes of ports to call, crew or passenger changes. Note 3. Mandatory regular position reporting at least every 6 hours for vessels carrying IMDG cargo, tankers and fishing vessels inside Icelandic waters: Vessels shall report their position 6 hours prior to entry into Icelandic Exclusive Economical Zone (IEEZ). Vessels participating in bilateral tracking with Iceland are exempt from regular position reports, and AIS vessels within the Icelandic AIS coverage area, (approximately 50 nm from shore) as indicated by AIS equipment. "Note 4: Control and compliance measures regarding ISPS. Iceland requires ships intending to enter its ports to provide the following information to the MTS before entry to port: 1. that the ship possesses a valid ISSC Certificate and the name of its issuing authority 2. the security level at which the ship is currently operating 3. the security level at which the ship operated in 10 last previous ports where it has conducted a ship/port interface. 4. any special or additional security measures that were taken by the ship in 10 last previous ports where it has conducted a ship/port interface. 5. that the appropriate ship security procedures were maintained during any ship to ship activity within the timeframe specified in paragraph 3. and 4. 6. other practical security related information (not details of the ship security plan), taking into account the guidance given in part B of the ISPS Code." Note 5: Vessels heading for Icelandic ports shall indicate IMDG, fuel and other oil quantities onboard by type when departing port enroute to Iceland. Report the correct technical names of the dangerous or polluting goods, the United Nations (UN) numbers where they exist, the IMO hazard classes in accordance with the IMDG, IBC and IGC Codes and, where appropriate, the quantities of such goods and their location on board and, if in portable tanks or freight containers, their identifications marks. And finally, Address from which detailed information on the cargo may be obtained. All fishing vessels heading for ports in Iceland must fill in the following fields. A. Former Fishing Area: B. Fished for: C. Reason for port call: D. Estimated position and time of entry into Icelandic EEZ E. Catch onboard: Species:Quantity: Total:0