New Zealand Gazette – 2004 – No. 138

Page 3405

✨ Maritime Outward Report Form



28 OCTOBER 2004

NEW ZEALAND GAZETTE, No. 138

3405

Rule 4(a)

Form C2

OUTWARD REPORT

(SHIPS AND BOATS OTHER THAN SMALL CRAFT)

Te Mana Arai o Aotearoa

PART A: DEPARTURE DETAILS

Name of ship Port of departure
Date of departure Time of departure
Name of person in charge
IMO number
Gross register tonnes
Segregated ballast tanks total tonnage (Tankers only)

LIST PORTS VISITED WHILE IN NEW ZEALAND ON THIS VOYAGE (Please record on a separate sheet and attach if additional space is required.)

New Zealand ports visited Date of arrival Date of departure
1.
2.
3.
4.
5.

LIST OVERSEAS PORTS EN ROUTE TO PORT OF DESTINATION (Please record on a separate sheet and attach if additional space is required.)

Total number of crew on departure Total number of crew embarked in New Zealand Total number of passengers on departure Total number of passengers embarked in New Zealand

CARGO

Has cargo been loaded onto the craft in New Zealand, whether originating in New Zealand, or transshipped in New Zealand for export? YES □ NO □

If YES, state the number of Outward Cargo Reports intended to be given and the names of the persons who will be giving them.

Please record on a separate sheet and attach if additional space is required.

Number

TANKERS ONLY: Total tonnage of persistent (P) and non persistent (NP) oil carried.

New Zealand ports visited P oil carried on arrival P oil loaded NP oil carried on arrival NP oil loaded
1.
2.
3.
4.
5.

DECLARATION

I hereby declare this Outward Report, comprising parts A, B, and C, is true and correct.

Signature of Person in Charge ........................................................... Date ....................................................

PART B: SUPPORTING DOCUMENTS CHECK LIST

Note: The following documents should be attached to this report (if applicable):

Passenger list attached YES □ NO □ Transit passenger list attached YES □ NO □
Craft stores requisitions attached YES □ NO □ Controlled drugs and firearms list attached YES □ NO □
Cargo reports attached Number electronic Number manual

OFFICIAL USE: Documentation for Outward Report produced and Certificate of Clearance issued.

Signature of Customs officer ........................................................... Date ....................................................



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Online Sources for this page:

VUW Te Waharoa — PDF NZ Gazette 2004, No 138


Gazette.govt.nz — PDF NZ Gazette 2004, No 138




✨ LLM interpretation of page content

🚂 Outward Report for Ships and Boats

🚂 Transport & Communications
Maritime, Shipping, Outward Report, Cargo, Crew, Passengers, Customs, Form C2