HEAD OFFICE CONTIGENCY PSMM/HOCP-06

PLAN Version : 00
PROCEDURE : HEAD OFFICE CONTIGENCY
Date: 04.01.2022
PLAN Page: 1/ 1

LOSS OF LIFE CHECK LIST

Name of vessel :...................................................

1 Incident reported Date: Time:

2 Reported by
3 Position of vessel N/S 0
' E/W 0
'

4 Name of victim
5 Type of incident

6 Cause of incident

7 Insurance Company informed

8 Next of kin informed

9 Flag state authority informed

10 Statement witnesses received

11 Other persons injured

12 Legal advice

13 Transportation victim

14 All events logged

Other information (if any)

PVTRANS SHIPS MANAGEMENT CO. – PSM