Form No: BULK/010

NOTE OF SEA PROTEST

Port:

Country:

BE IT KNOWN THAT ON THIS ……………………….DAY OF ………………………………………..

AT …………………………………………….HRS BEFORE ME A

NOTARY PUBLIC ……………………………………………DULY COMMISSIONED AND SWORN

PERSONALLY APPEARED, Capt. ……………………………………MASTER OF THE MOTOR

VESSEL CALLED THE …………………………………………………………….OF THE BURDEN OF

…………………..GRT OR THEREABOUTS, OFFICIAL NUMBER: ……………………………

PORT OF REGISTRY …………………………….. AND DECLARED THAT ON OR ABOUT THE

DAY OF LAST PAST HE SAILED IN AND WITH SAID VESSEL AS MASTER THERE FROM

…………………………………………….BOUND FOR ………………………………………………….

HAVING ON BOARD SAID VESSEL A CARGO OF …………………………… AND ARRIVED AT

ANCHORAGE / BERTH ON ………………………………………, BERTHED ON

……………………………………….. AND

During this period on & ,she experienced boisterous weather conditions and she Rolled /
Pitched heavily at times, violently making her Shudder / Pound. Vessel shipped Heavy Seas Forward
on Forecastle, Main Deck Port and Stardboard, Top of Hatch Covers no…….1…to 9 and Spray
Allover. Vessel’s Speed adjusted to avoid heavy Rolling / Pitching and Pounding.

Fearing further damage to the VESSEL, VESSEL’S MACHINERY and CARGO carried and thus he
hereby notes a PROTEST reserving the RIGHT TO EXTEND same to convenient TIME, DATE and
in event of any DAMAGE or CLAIM to the VESSEL.
And further he declares that due to Circumstances beyond his control he was unable to lodge protest
earlier.

Enclosures:
1. A copy of Deck Log book abstract
2. A copy of Official Logbook entry
3. A copy of weather reports.

IN WITNESS WHEREOF:

NOTARY PUBLIC MASTER

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