+ANNEX II

ANNEX II

ANNEX II

DISSOSTICHUS CATCH DOCUMENTDocument NumberFlag State Confirmation NumberPRODUCTION SECTION1. Issuing Authority of DocumentNameAddressTel.Fax2. Fishing Vessel NameHome Port & Registration NumberCall SignIMO/Lloyd's Number (if issued)3. Licence Number (if issued)Fishing dates for catch under this document4. From:5. To:6. Description of Fish (Landed/Transhipped)7. Description of Fish SoldSpeciesTypeEstimated Weight to be Landed (kg)Area Caught (*)Verified Weight Landed (kg)Net Weight Sold (kg)Recipient name, address, telephone, fax and signature.Recipient Name:Signature:Address:Tel.FaxSpecies: TOP Dissostichus elegonoides, TOA Dissostichus mawzoni Type: WHO Whole: HAG Headed and gutted; HAT Headed and tailed; FLT Fillet; HGT Headed, gutted, tailed; OTH Other (specify)8. Landing/Transhipment Information: I certify that the above information is complete, true and correct. If any Dissosatichus spp. was taken in the Convention Area, I certify that it was taken in a manner which is consistent with CCAMLR conservation measures.Master of Fishing Vessel or Authorised Representative (print in block letters)Signature and DateLanding/Transhipment Port and Country/AreaDate of Landing/Transhipment9. Certificate of Transhipment: I certify that the above information is complete, true and correct to the best of my knowledge.Master of Receiving VesselSignatureVessel NameCall SignIMO/Lloyd's Number (if issued)Transhipment within a Port Area: counter signature by Port Authority if appropriateNameAuthoritySignatureSeal (Stamp)10. Certificate of Landing: I certify that the above information is complete, true and correct to the best of my knowledge.NameAuthoritySignatureAddressTel.Port of LandingDate of LandingSeal (Stamp)EXPORT SECTION — TRANSPORT DETAILSIf by sea/air:Container number(if more than one — attach list)If no container:Vessel name: ORFlight number; ANDBill of lading/airway bill number; ANDDate and place of issueIf ground transport:Truck registration number and nationality; ORRailway transport number; ANDDate and place of issue

11. Description of Fish Exported12. Exporter Declaration: I certify that the above information is complete, true and correct to the best of my knowledge.SpeciesProduct TypeNet WeightNameAddressSignatureExport Licence (if issued)13. Export Government Authority Validation: I certify that the above information is complete, true and correct to the best of my knowledge.Name/TitleSignatureDateCountry of export seal (Stamp)14. IMPORT SECTIONName of ImporterAddressPoint of Unlading:AddressState/ProvinceCountryCity(*) Report FAO Statistical Area/Sub-area/Division where catch was taken and indicate whether the catch was taken on the high seas or within an EEZ.

1. Forbhreathnú

,

1.1 Tagairtí

1.2 Ceanglais aitheanta

1.3 Caighdeáin ghaolmhara

2. Ceanglais aitheanta

Ceanglais

3. Caighdeáin ghaolmhara

Caighdeáin
  • Builddate: 06.10.2006 00:00:00 -Doknr: CELEX:32001R1035
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