Maritime Stowaway Statement
1. Vessel & Stowaway Details
Vessel Name
IMO Number
Date Found
Port Found
Discovered By
2. Stowaway Identity Information
Full Name
Gender
Nationality
Date of Birth
Identification No./Passport No.
3. Statement by Stowaway
Language Used for Statement
Statement
4. Interview Details
Date of Interview
Location
Interviewer Name/Rank
5. Signature
Stowaway Signature
Date
Interviewer Signature
Date