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2014-10-017 Rev 1 Immigration Boarding Formalities
BI immigration boarding formalities for joining/repatriation
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IMMIGRATION BOARDING FORMALITIES
Name of Vessel/Ship
Voyage Number
A-SIDE
OBW
Flag
Port of Registry
Date of Arrival [DD-MMM-YYYY e.g. 01 JAN 1990]
Anchorage Time [e.g. 1525H]
Date Boarded [DD-MMM-YYYY e.g. 01 JAN 1990]
Time Boarded [e.g. 1525H]
Date of Departure [DD-MMM-YYYY e.g. 01 JAN 1990]
Estimated Time of Departure [e.g. 1525H]
H
H
H
Pier
Last Port
Next Port
Visa Number
Date of Issuance [DD-MMM-YYYY e.g. 01 JAN 1990]
Place of Issuance
Nationalities of Crew Members:
Number
Passengers
Landing Passenger
Transit
Stowaway
Passenger Who Needs
Medical Attention
Disembarking Crew (Sign off)
Crew Who Needs
Medical Attention
TOTAL
TOTAL
Boarding Launch: ____________________________________ Agent: ______________________________________________
Remarks: _______________________________________________________________________________________________
I, Captain __________________________________________, master of _____________________________, do hereby
solemnly swear (or affirm) to the best of my knowledge and belief that the above information is true and correct in every aspect.
___________________________________
MASTER’s Signature over Printed Name
SUBSCRIBED AND SWORN TO before me this _____day of __________________________, 20____ at the port of
_______________________, Philippines.
_________________________________________
Immigration Officer’s Signature over Printed Name
CERTIFICATION
TO WHOM IT MAY CONCERN:
This is to certify that _________________________________________ Immigration Officer/s boarded my vessel
_____________________________________________ upon arrival at the port of ____________________________ and
performed his/her/their duties that are required of him/her/them and stayed up to departure time.
That during his/her/their stay in my vessel at the Philippine ports, said Immigration Officer/s did not avail of free meals served
on board due to his/her/their preference of their native dishes.
________________________________
MASTER’s Signature over Printed Name
_______________________________
VESSEL
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