Livestock Carrier Port Declaration

Vessel Information

Vessel Name IMO Number
Flag Call Sign
Voyage Number Date of Arrival
Master's Name Port of Loading
Port of Discharge Previous Port

Livestock Details

Species Number Pens Used

Health and Welfare

Number of Mortalities Number of Sick Animals
Veterinarian on board? Medicines Given

Declaration

I hereby declare that the above information is complete and correct to the best of my knowledge.
Name of Declarant:
Signature:
Date:
Position: