Completed worksheet may be emailed to

United States Coast Guard sans@nvmc.uscg.gov

National Vessel Movement Center

NOTICE OF ARRIVAL
(33 CFR 160)

Vessel Name Call Sign Vessel ID Number Country of Registry

IMO Official No.

Registered Owner Operator Classification Society

DOCUMENT OF COMPLIANCE CERTIFICATE SAFETY MANAGEMENT CERTIFICATE

Date of Issuance Issuing Agency Date of Issuance Issuing Agency

OPERATIONAL CONDITION OF EQUIPMENT If Not Operational, describe:

Operational Not Operational Not Required

Reporting Party Name Reporting Company Reporting Party Telephone Number

Vessel's Current Position

Name of Vessel's Charterer (Latitude/Longitude, place, waterway/mile marker)
Date & Time of Report

VOYAGE INFORMATION
U.S. Destination Port or Place/City & State Estimated Date & Time of Arrival Estimated Date & Time of Departure

U.S. Destination Receiving Facility/Terminal/Anchorage U.S. Coast Guard Captain of the Port (COTP) Zone

Point of Contact (POC) POC 24 Hour Telephone Number POC Fax Number

CONSECUTIVE PORTS OF CALL FOR CURRENT VOYAGE

24-hour POC Est Date & Time Est Date & Time
Receiving Facility Port or Place City & State (Name & Telephone Number) Arrival Departure

CARGO AND PREVIOUS PORTS

General Description of Cargo Cargo Amount Certain Dangerous Cargo (CDC) Onboard?

Yes No
Last Five Ports/Places Visited Date of Arrival Date of Departure

Notice of Arrival (NOA) Vessel & Voyage Information, Version 4.0, December 18, 2003 1 of 6