| Name of ship:
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| IMO number/call
sign:
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| Flag State:
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| Gross tonnage:
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| Deadweight (where
appropriate):
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| Date of report:
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| Report by:
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| Classification
Society:
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| Recognized
Organization involved:
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| .................................................................................................................................................
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| □
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Did you receive
the notification of detention? (tick the box if the answer is
"yes")
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| Action
taken
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a) Deficiencies
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b) Cause
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c) Action taken
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| Additional
Information:
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