The vessel Master is to submit this form at least 24 hours before the vessel’s arrival. *Mandatory fields. Vessel Name(Required)IMO No.(Required)Master Name(Required)E.T.A Date(Required) DD slash MM slash YYYY E.T.A Time(Required) Hours : Minutes AM PM AM/PM E.T.A Location(Required)Select locationBerthPilot Boarding GroundArrival Draft(Required) First Last Departure Draft(Required) First Last L.O.A(Required)GRT(Required)Berthing Displacement(Required)Bridge Mark, Bow to Bridge for Vessels >100m(Required)Preferred Side(Required) P S Protrusions or Overhang from Ships Side (E.g. Rubbing Strake, Door Sills, Davits etc.) Height From:WL(Required)Length(Required)Depth(Required)VHF(Required) Yes No Steering Gear(Required) Yes No Mooring/Winches(Required) Yes No Gyro Compass(Required) Yes No Radar(Required) Yes No AIS(Required) Yes No Bow Thruster(Required) Yes No Ability to Run Continuous 100% for 15 minutes(Required)Main Propulsion(Required) Yes No Pilot Ladder(Required) Yes No If No to Any Item Please Provide DetailsBunker Point from Below (metres)(Required)Number and Diameter of Mooring Lines(Required)Mooring line MUST have fitted to the eye a 2 metre light rope tail to be connected to heaving or messenger line.Type of Rope/Line(Required)Pilotage Requirements Pilotage is compulsory. The bridge team is to familiarise themselves with the Port and Terminal Handbook.Pilot Required Inwards?(Required) Yes No Pilot Required Outwards?(Required) Yes No If NO Pilot is required please provide exercising Pilot Exemption details.PEC NumberRestrictionsExpiry date DD slash MM slash YYYY Berthing/Anchorage RequirementsBerthing on Arrival?(Required) Yes No If No, please contact operations for allocation of an anchorage: operations@kimberleyports.wa.gov.au (08) 9194 3100 or 0417 173 679 Anchorage must be allocated by the Kimberley Ports Authority before a vessel anchors in Port limits.Anchorage on arrival(Required) Yes No Anchorage on departure(Required) Yes No Contact InformationEmail Address(Required) Contact Number(Required) Δ