Form No.

: MSO-18
Revision No:/Date: 0/13 June 2002

Maritime Safety Office

SCREENING OFFICER’S CHECKLIST FOR THE
ISSUANCE OF SPECIAL PERMIT TO NAVIGATE (SPN) CONDUCTION FOR DRYDOCKING
PURPOSES

Y N
1. Letter of Application
2. Photocopy of the vessel CI

__________________________________________
Screening Officer (signature over printed name)
Date:
Application Control No.: (to be copied by Records from the DtrackS Form No. 1)
Action Taken: __________________________ Amount P_______________ OR#__________
Remarks: _______________________________________________________________________
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