Chittagong Port Authority

www.cpa.gov.bd

Marine Department

Date:

Ship Security Incident Record Register

Incident Date & Time:

Master Reported Date & Time:

a. Name of the Ship:

b. IMO Number:

c. Flag of the ship:

d. Name of the Captain:

e. Nationality of the Capt:

f. Anchorage/Berth:

g. GPS Position:

h. Cargo Description:

j. Security Level of the Ship:

k. Local Agent:

l. Last port of call:

m. Next port of call:

n. Description of Occurrence:

p. Action Taken:

Assistant Harbour Master (ISPS) Name:

Assistant Harbour Master (ISPS)

Deputy Conservator Name:

Deputy Conservator