| Report No. | |
| Date of Inspection | |
| Inspector Name | |
| Contact Details | |
| Vessel Name | |
| Voyage No. | |
| Bill of Lading No. | |
| Consignee | |
| Consignor | |
| Port of Loading | |
| Port of Discharge |
| Cargo Description | |
| Quantity / Weight | |
| Type of Packaging | |
| Container / Package No. | |
| Seal No. |
| Nature of Damage | |
| Extent of Damage | |
| Location of Damage | |
| Date & Time Noticed | |
| Possible Cause |