MPA Agent Berth Application Form


* All times reffered to are in Australian Eastern Standard Time UTC+10 hours.

This vessel is accepted into this security regulated port under the provisions of the Maritime Transport Security Act and Regulations 2003 on the basis that the Designated Authority for Australia, the Department of Transport and Regional Services, has not provided advice to this port that this vessel cannot be accepted for security reasons. This port will not accept any liability resulting from any decisions either made or not made or advice given or not given by DOTARS on security matters under the MTSA 2003

I/We hereby declare that I/We are duly appointed agent for the owner of the vessel:
And I / We gaurantee to pay the Authority all harbour dues and other charges payable in respect of such vessel or goods.
* Expected time of arrival of the vessel at the anchorage to be: DD MM YYYY @ 24Hr : Min
* and hereby make application to berth at Berth No on the DD MM YYYY @ 24Hr : Min
With on board.
I / We notify that there are no unusual circumstances with regard to the vessel or its cargo except for:
Master of Vessel (Full Name):
Arrival Draft Fwrd: Arrival Draft Aft:
Departure Draft Fwrd: Departure Draft Aft:
Freeboard Amidships (Arrival):
Last Port: Next Port:
Particulars of Disposable Wastes:
Hatch Numbers for Discharge/Loading this Port:
* Discharge/Load will commence on: DD / MM / YYYY @ 24Hr : Min
* Date & Time of Sailing for this Port: DD / DD / YYYY @ 24Hr : Min
Equipment Engaged (Trucks/Endloaders):
The following Services are Requested:
Items of Note
 

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