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IMO CREW LIST

Page No.
Arrival Departure

1. 2. Port of 3. Date of arrival/departure


1 arrival/departure
N

1.
2
I

1.
3
C

4. Flag State of ship 5. Last port of call 6. Nature and No. of


identity document
(seaman’s
passport)
Convention on Facilitation of International Maritime Traffic

7. No. 8. Family name, 9. Rank or 10. Nationality 11. Date and place
given names rating of birth

IMO
FAL
Form 5
12. Date and signature by master, authorized agent or officer

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