Relevant Port Authorities / Flag State / Shipowner / P&I Club From: Master of [Vessel Name] Date of Report: [DD/MM/YYYY] 1. Vessel Information Vessel Name/IMO Number: [e.g., MV Blue Horizon / 1234567] Flag State: [e.g., Panama] Current Position: [Latitude/Longitude at time of discovery] Last Port of Call: [Name and Departure Date/Time] Next Port of Call: [Name and ETA] 2. Incident Details Date/Time of Discovery: [Time and Date stowaway was found]
[e.g., Routine inspection, security search, or tip from agent] Number of Stowaways Found: [Total Count] 3. Stowaway Information (Per Individual) Claimed Name/Alias: [Full Name] Claimed Nationality: [Country] Date of Birth/Age: [Approximate if unknown] Stowaway
[General physical and mental health; record any injuries or immediate medical needs] 4. Actions Taken by Crew Relevant Port Authorities / Flag State / Shipowner
[Where the stowaway claims to have boarded] page 1 - International Maritime Organization
FAL 42/17 Annex 1, page 1 - International Maritime Organization
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