APPENDIX
-
FORM NO. 1.
Pilot
(name)
Nationality
Names of Owner and Agent of Vessel:
Owner:
Agent:
•
Company:
...
Classification and name of vessel: S/S
Gross Tonnage:-
...
tons
:
119
...
/"
11
Maru
Classification and quantity of cargo:
(f.i. miscellaneous goods (or coal) ... tons)
Total length:-
Draught at bow:
at stern:.
Zone of pilotage:...
...
metres (feet)
...
metres (feet)
metres (feet)
Time of Embarkation:
Month
.....
day
a.m. minutes
p.m.
minutes
Time of Disembarkation:
Month
.....
day
a.m.
minutes
p.m.
minutes
Pilotage fee:
I certify that the above-mentioned pilot
has guided this vessel.
.....
Year
......
Month
... Day.
Captain.