BPA Form 1036

Fourth Edition
2 August, 2019
NOTICE OF ARRIVAL
This form is to be completed and submitted to the Belize Port
Authority No later than 48 hours in advance of the vessels intended
arrival.
Ship’s Particulars
Country of Registry: ________________ REG #: ________________
Name of Vessel: ____________________
Voyage Number: ___________________ Call Sign: ________________________ Type: __________________

IMO Number: ______________________ DWT: ___________________________ LOA: __________________

Name of Master: ____________________ Draft Fwd: _______________________ Beam: _________________

Draft AFT: _______________________ No. Ratings: ____________

Gross Tonnage: _____________________
Net Tonnage: ______________________ Number of Crew: __________________ No. of PAX: ____________
Security
ISSC Number: ________________ ISSC Issue Date: _______________ ISSC Exp. Date: __________________

Current Security Level: _________ Last Port of Call: _______________ Next Port of Call: _________________

Last Ten Port of Call:
1._____________________ 2.____________________
3._____________________ 4.____________________
5._____________________ 6.____________________
7._____________________ 8.____________________
9._____________________ 10.___________________
Port Activity
Security related incident over the last ten Port of Call
N/Y (If “Yes” Explain)
_______________________________________________________
_______________________________________________________
_______________________________________________________
_______________________________________________________

To Berth: Y N To Anchorage: Y N Other: 

Purpose of Visit: Load  Unload  Pleasure  Research 

Other (Explain) ___________________________________________________________________________________________

ETA Territorial Waters: __________________ Date: ______________ ETA Pilot Station: _______________________
Port of Call in Belize: ___________________ Date: ______________ ETD: __________________________________

Dangerous Goods Y N
If yes, please complete and fax the Belize Port Authority’s Dangerous Goods form for approval to 501-222-5665/5666
Communications
Radio:  Working Frequency: _________________ Email: _______________________ Tel No: ______________

Vessel’s Operator: ____________________________________________________________________________________________

(Name, Address, Contact Number)

P & I Club: _________________________________________________________________________________________________

(Name, Address, Contact Number)

H & M Insurers:______________________________________________________________________________________________
(Name, Address, Contact Number)

Date: _______________________________________
Name of Master/Agent: ________________________
Signature: ___________________________________
NOTE: All vessels are required to communicate to the National Maritime Communications Center on channel 16, their arrival within territorial waters and
the Level of Security currently in effect.

P.O. Box 633Mile 4, George Price Highway, BelizeTel:501-222-5666/5665Email: documentation@portauthority.bz