ISM Safety Management System Evaluation Form

General Information

Vessel Name IMO Number Company Name Date Auditor Name

Evaluation Criteria

Criteria	Compliance	Comments
ISM Policy Understanding	Compliant Non-Compliant N/A
Reporting Procedures	Compliant Non-Compliant N/A
Emergency Preparedness	Compliant Non-Compliant N/A
Resource & Personnel Competence	Compliant Non-Compliant N/A
Maintenance of Ship & Equipment	Compliant Non-Compliant N/A
Documentation & Records	Compliant Non-Compliant N/A

General Remarks

Auditor's Signature