IMO GENERAL DECLARATION

Arrival Departure
1. Name and description of ship 2. Port of arrival/departure 3. Date/time of Arrival/departure
MT.ASIA 38 & BG, JOHAN GLORY 2 PASIR GUDANG, JOHOR 04 -07-2009 @ hrs
4. Nationality of ship 5. Name of Master 6. Port arrival from / port of destination
MALAYSIAN SUYANTO PORT KLANG / PASIR GUDANG
7. Certificate of registry ( Port, Date, Number ) 8. Name and address of ship's agent
MALAYSIA SHIPLINK AGENCY SDN BHD
9. Gross tonnage 10.Net tonnage PLO 508,JLN TIMAH,
463.00 / 2714.00MT 138.00/814.00 MT KAWASAN PERINDUSTRIAN
11. Position of the ship in the port (Berth) PASIR GUDANG, JOHOR
CONTAINER TERMINAL 1
12. Brief particulars of voy (Previous & subsequent port of call; under line where remaining cargo will be disharged

13. Brief description of the cargo

CONTAINER
14. No. of crew (Ind. Master) 15. No of passengers 16. Remarks

15 PERSON - MALAYSIA = 2
Attached document (Indicate number of copies) INDONESIAN = 7

- MYANMAR = 6
17. Cargo declaration 18. Ship's stores declaration

CONTAINER - TOTAL = 15
19.Crew list 20. Passenger list

1 -
22. Crew effects Declaration 23. Maritime Declaration of Health

M.T ASIA 38 / BG. JOHAN GLORY 2

SUYANTO

For Official Use