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- Category: Philippines Legal Form
- Hits: 9102
(Marine Protest by Ship Captain)
Republic of the Philippines)
Province of ____________________) S.S.
City/Municipality of _____________)
x - - - - - - - - - - - - - - x
Name: ______________ Age: _____Civil Status: _______
Position: __________________Type/Cargo: ___________
Home Port: ___________________________________
Registry Number: ___________________________
Gross Tons:_____________ Net Tons: ____________
After being duly sworn to in accordance with law, do hereby declared and state on protest. That on (continue with facts and circumstances that transpired in the______________________incident)
That I, as Master, (Indicate what actions the master initiated _________________________.
That I as Master (Indicate the respondents and their address if any.)____________________________________.
That I as Master (Indicate the respondents and their address if any.) _________________________________.
That the prevailing weather at the time was as follows:
General Description: ______________________
Wind Direction: _______Velocity: ____ Kits: _________
Height of Seas: _________Feet: ____________
Tide: __________________ Flood ____________
Other Remarks: _____________________
That the incident resulted injuries to ___________________ persons and death to _____________ persons, whose names are listed in Exhibit "A" of this PROTEST
That this incident likewise resulted to loss or slight damage to the _____________ belonging to _____________ in the estimated amount of ______________________________ (P____________) and detailed in Exhibit "B" of this PROTEST:
That my organization / shipping company is as follows:
That further/additional information/data is appended hereto as Exhibit "1" of this PROTEST.