CARGO DAMAGE REPORT

(Standard Form of ( name of company)

Name of Vessel: MV / SS ________________ Date of Report: _________________

Voyage No.: __________In transit _________ At port: ________________________
Name of Master: _______________________ Name of Owner: ________________
Name of Owner’s P & I Club: _____________
1.B/L No.(S/O No.): 12. Exception at
Discharging:
2. Marks and 13. Name of
Numbers: Chief Officer:
3.Kind and Amount 14. Name of
of Cargo: Responsible
Officer:
4. Quantity of 15. Date of Note
Damaged Cargo: of Protest:
5. Port of Loading: 16. Name of
Port where the
above is taken:
6. Port of 17. Name of
Surveyor (If
Discharge:
Appointed):
7. Shipper: 18. Name of
Witness (If Any):
8. Consignee: 19. Extent of
Damage:
9. Stowage: 20. Cause of
Damage:
10.Kind of Damage: 21. Disposition
of Damage:

11. Exception at 22. Remarks

(Master’s
Loading:
Opinion):

Signed _________________
Master

Note
1. This Report is requested to send us when Cargo was damaged in the following cases:
a. Damage to Valuable cargo
b. Damage to Refrigerated cargo
c. Pilferage of cargo
d. Damage caused by improper stowage
e. Damage caused while cargo working
f. Large amount of shortland
g. Other important damage to cargo
2. For items 17, 18, 19, 20:
Please report details of damage using free form paper with Explanation drawing if needed.
3. Exception means Remarks on Mate’s Receipt or Bill of Lading
4. Send one Original and one copy to our cargo superintending team as soon as possible.
Created by A. CHALID PASYAH, M.Pd. Dip.Tesl.
 REPORT OF DAMAGED _____________
REF #__________________
Dear sir,

SUBJECT: ___________________________

We regret to inform you that the following deficiency and damaged to __________was found and
would like to place the __________or request for ____________of the aforementioned based on
given details below.

The detail of damage and precautions taken are reported as follow:

1. Date
2. Place
3. Description

4. Investigation

5. Treatment

6. Countermeasure

Your attention to the above mentioned would be highly appreciated.

Sincerely yours,

______________
Master of MV…..

Created by A. CHALID PASYAH, M.Pd. Dip.Tesl.