THE THIRD SCHEDULE
[ See rule 6(2)] � :
Issued by the
Government of India
OBSTRUCTION TO NAVIGATION
Report of Derelict Vessel, or Floating Wreckage, or Sunken Wreck
Queries Replies
1. Name and address of informant 1
2. Name and port of the vessel to which she belongs. 2.
3. Voyage. 3.
4. (a) Nature and size of obstruction 4. (a)
4. (b) Nature of danger to navigation 4. (b)
5. Name and port of derelict or sunken wreck 5.
if known, and if not known, any particulars
which might lead to its identification.
6. Description of the wreckage and any marks 6.
which might lead to its destination.
7. Date and hour when the derelict, wreckage, 7.
wreck was last seen and date and hour of
report made by radio telegraphy, if fitted.
8. If sunken wreck, the exact spot in which 8.
lying and the bearings of any fixed Object
that can be give a (Tracing from charge showing exact spot).
9. If a derelict or floating wreckage the place 9.
where last seen, and the direction in which drifting.
10. Whether the derelict was boarded by the 10.
informant or any of his crew.
11. Whether she was dismasted 11.
12. Whether she was waterlogged 12.
13. Whether she had capsized 13.
14. Did she appear to have been in collision. 14.
15. If laden, the nature of her cargo 15.
16. Was any attempt made to take her In tow 16.
or to destroy her, and if why not.
17. Any other particulars which the Receiver 17.
may think relevant.
18. Date of making this report 18.
19. Date of informing underwriters or their agents 19.
Note�The questions which do not apply should be struck-out.
Forwarded to the Principal Officer,
Mercantile Marine Department,
Dated,, this ���������day of �������.19
Signature Of Receiver
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