Sender Information
	Tick if willing to be named as source of this information
Name of Observer/Reporter
Name of ship or Office
Sex	Male Female
IMO Number
Address of sender
E-mail Address
Telephone/Mobile No.

Name of Port
Approximate Position
Port Authority Name and contact details
General Remarks Principal activities and trades. Latest population figures and date. Number of ship tonnage handled per year. Maximum size of vessel handled. Copy of Port Handbook (if available).
Berthing Facility Type (L-pier, T-pier, wharf, etc.) Names, numbers or positions and lengths. Depths alongside.
Storage Facility Area of open storage area and warehouse. Existence of reefers facilities, cold storage, and special storage facilities.
Anchorage Position, designation, depths, holding ground, shelter afforded.
Pilotage Authority for request. Pilot boarding position. Regulations (compulsory or not). Name of pilot association and contact details
Tugs Number available. Name of tug operator and contact details.
Directions Entry and berthing information. Tidal streams. Navigational aids.
Small Craft Facility Name of yacht club, contact no., email address.
Cargo Handling containers, ligters, Ro-Ro etc.
Repairs Hull, machinery and underwater. Shipyards. (Give size of vessels handled or dimensions) Divers.
Rescue and Distress Salvage, Lifeboat, Coastguard, etc. Name of nearest Coast Guard station and contact details.
Supplies Fuel (with type, quantities and methods pf delivery). Fresh water (with method of delivery and rate of supply) Provisions
Services Medical. Ship Sanitation. Garbage and slops. Ship chandlery, tank clearing, compass adjustment, hull painting.
Communications Nearest airport or airfield. Port radio and information service. (with frequencies and hours of operating)
Government Services Custom. Quarantine. Plant and Animal Quarantine. Immigration.
Local Situation Health facilities (nearest hospitals, clinics, health centers) Bank and money remittance facilities.
Views Photographs (where permitted) of the approaches, leading marks, the entrance to the harbour etc.