LSS/R/(101)

Serial No :

LEMBAGA SUNGAI- SUNGAI SARAWAK

(SARAWAK RIVERS BOARD)

APPLICATION FOR ANCHORAGE

SARAWAK RIVERS (TRAFFIC) REGULATIONS, 1993

(TO BE SUBMITTED IN DUPLICATE 24 HOURS BEFORE SHIP ARRIVAL)

Name of Vessel : …………………………………………………….

Official No. : ………………………………………………………..

River Transport
Port of Registry : …………………………………………………….
Permit No : ………………………………………………………..

Length Overall : …………………………………………………….

Draft : ……………………………………………………….

Gross Tonnage : …………………………………………………….

Net Tonnage : ……………………………………………………….

Name of Master : …………………………………………………………………………………………………………………………

Name and Address of Agent/ Owner

(Telephone and Fax No.)
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Date and Time Expected Arrival at Anchorage : ………………………………………………………………………………………….

Port Of Arrival : ……………………………………………………………………………………………………………………….

Date and Time Expected Departure From Anchorage : ……………………………………………………………………………

Port of Departure: …………………………………………………………………………………………………………………………

Berthing Area : ……………………………………………………………………………………………………………………………..

Type and Quantity of Cargo Loaded : ………………………………………………………………………………………………

Type and Quantity of Cargo Discharged ………………………………………………………………………………………………

FOR OFFICIAL USE

Approved/ Not Approved

…………………………………………………………………
CONTROLLER
(Sarawak Rivers Board)
BILLING

Anchorage Fees Banker's Guarantee

Gross Ton …………………………………………………………… Name of Bank : ……………………………………………………….

Rate ………………… x ……………………. Days ……………….. Guarantee No: ……………................................................................

Cash/ Cheque No : ………………………………………………….. Amount : ………………………………………………………………

Receipt No : ………………………………………………………… Validity Period : ……………………………………………………….

Date : …………………………………………………………………

Issued By : …………………………………………………………..

( Crossed Cheque Payable to

Sarawak Rivers Board)

Harga Borang Rm1.00 Satu Set