Casualty

ANNEX 1

IMO MARINE CASUALTY AND INCIDENT REPORT

SHIP IDENTIFICATION AND PARTICULARS

Administrations are urged to supply the ship identification information listed in this annex for all marine casualty reports submitted to the Organization.

SHIP PARTICULARS

1. IMO Number:

2. Name of Ship:

3. Flag State:

4. Type of Ship

.1 Liquefied Gas Tanker ο

.2 Chemical Tanker ο

.3 Oil Tanker ο

.4 Other Liquids (non-flammable) Tanker ο

.5 Bulk Dry (general, ore) Carrier ο

.6 Bulk Dry / Oil Carrier ο

.7 Self-Discharging Bulk Dry Carrier ο

.8 Other Bulk Dry (cement, woodchips, urea and other specialized) Carrier ο

.9 General Cargo Ship ο

.10 Passenger / General Cargo Ship ο

.11 Container Ship ο

.12 Refrigerated Cargo Ship ο

.13 Ro-Ro Cargo Ship ο

.14 Passenger / Ro-Ro Cargo Ship ο

.15 Passenger Ship ο

.16 High Speed Craft ο

.17 Other Dry Cargo (livestock, barge, heavy cargo, etc.) Carrier ο

.18 Fish Catching Vessel ο

.19 Fish Factory Ship / Fish Carrier ο

.20 Offshore Supply Ship ο

.21 Other Offshore Ship ο

.22 Research Ship ο

.23 Towing / Pushing Tug ο

.24 Dredger ο

.25 Other Activities Ship ο

.26 Non-Propelled Ships ο

.27 Other Ships Structures ο

5. Gross Tonnage:

6. Length overall:

7. Classification Society:

8. Registered Shipowner:

9. Ship Manager/Operator:

10. Previous names:

11. Previous Flag:

12. Previous Class Society:

13. Date of contract/keel laid/delivery:

14. Date of major conversion:

15. Deadweight:

16. Hull material

.1 steel ο

.2 light alloy ο

.3 ferrocement ο

.4 wood ο...