ANNEX IIIASupplementary provisions
ANNEX IIIA Form for pre-landing declarations referred to in Article 3(1) Text of image Vessel identification 1. Vessel name: 2. Type of vessel (catching or carrier): 3. Flag (country of registration): 4. Home port (ISO alpha-2 country code + name of port): 5. Registration number (external identification): 6. International radio call sign: 7. IMO/Lloyd’s number (if issued): Contact 8. Name of the master/representative: 9. Address of master/representative: Departure information 10. Dates and time of departure: 11. Port of departure (ISO alpha-2 country code + name of port): Landing information 12. Date and estimated time of landing: 13. Intended port of landing (ISO alpha-2 country code + 3 letter port code (*)): 14. Sent by master/representative: Quantities of species retained on board 15. Catch certificate number(s), date(s) and flag State(s) 16. Date of transhipment (if transhipment has taken place elsewhere than the port of landing) and name of catching vessel(s) 17. Area or port of transhipment (FAO (ICES) area, FAO (ICES) division, FAO (ICES) subdivision and if relevant ICES statistical rectangle) 18. Name of the species (FAO alpha-3 code) 19. Catch area (FAO (ICES) area, FAO (ICES) division, FAO (ICES) subdivision and if relevant ICES statistical rectangle and fishing effort zone) 20. Estimated total live weight on board (in kg) or number of fish if required 21. Estimated total live weight of fish to be landed (in kg) or number of fish if required 22. Presentation of fish and state of preservation (use letter codes (*)) 23. If applicable, conversion factor applied to fishery product by flag State 24. If processed fishery products, processing’s type of packaging (3 letter code CRT=cartons. BOX=boxes, BGS=bags and BLC=blocks) 25. If processed fishery products, number of packing units (cartons, boxes, bags, containers, blocks etc.) 26. If processed fishery products, average weight per unit of packing (in kg) 27. Name and address of vessel owner: 28. Name of master of vessel/representative: 29. Signature: 30. Date: If catching vessel fill in points 1-15 plus 18-30 If carrier vessel fill in all points