Notice of

United States Coast Guard Vessel Arrival Completed form may be sent via
National Vessel Movement Center (33 CFR 160) email to sans@nvmc.uscg.gov

IMO Lloyds Official No.

Registered Owner Operator Classification Society

Reporting Party Name Reporting Party Telephone Number Reporting Company

Vessel's Current Position Date of Report Time of Report

(Latitude/Longitude)

Document of Compliance Certificate

Date of Issuance Date of Expiration Issuing Agency

Safety Management Certificate

Date of Issuance Date of Expiration Issuing Agency

Current Voyage Information

Last Port of Call (LPOC) LPOC Date of Departure LPOC Time of Departure

U.S. Destination Port Estimated Date of Arrival at U.S. Port Estimated Time of Arrival at U.S. Port

U.S. Destination Dock/Pier/Terminal/Anchorage Captain of the Port (COTP) Zone

Estimated Date of Departure Estimated Time of Departure Next Port of Call

Agent Agent 24 Hour Telephone Number Agent Fax Number

Type of Cargo (Gen., Bulk, Liquid, etc.) Amount Hazardous Materials Onboard?
Yes No

Additional Ports of Call

Port/Dock/Pier/Address 24-Hour Telephone Estimated Date and Time of Arrival Estimated Date and Time
and COTP Zone Number of Departure