Vessel Ship Sanitation Control Exemption Certificate
Issued under the International Health Regulations (IHR 2005)
Certificate No.:
Ship Information
Name of Ship:
IMO Number:
Flag State:
Port of Registry:
Gross Tonnage:
Date of Arrival:
Last Port of Call:
Next Port of Call:
Name and Address of Ship Owner:
Inspection Details
Date of Inspection:
Place of Inspection:
Areas Inspected:
Statement
Valid Until
Expiry Date:
Signature of Authorized Officer
Official Stamp