ISPS Code - Declaration of Security (DoS)
1. Location and Contact Information
Ship Name:
IMO Number:
Port Facility:
Date:
Ship Security Officer:
Contact Details:
Port Facility Security Officer:
Contact Details:
2. Security Levels
|
Security Level |
Applicable? |
| Ship |
|
|
| Port Facility |
|
|
3. Activities Requiring Agreement of Security Measures
| Activity/Interface |
Ship's Responsibility |
Port Facility's Responsibility |
| Access control |
|
|
| Cargo handling |
|
|
| Delivery of ship's stores |
|
|
| Unaccompanied baggage |
|
|
| Monitoring restricted areas |
|
|
| Response to security threats |
|
|
4. Other Security Measures Agreed
5. Duration of the DoS
From: To:
Time: Time:
6. Signature
Ship Security Officer
Name:
Signature:
Date:
Port Facility Security Officer
Name:
Signature:
Date: