Name and IMO number of receiving ship |
Port |
Date of commencement of delivery |
Name, address, and telephone number of marine fuel oil supplier |
Product name(s) |
Quantity (metric tons) |
Density at 15°C (kg/m3)* |
Sulphur content (% m/m)† |
A declaration signed and certified by the fuel oil supplier's representative that the fuel oil supplied is in conformity with regulation 14(1) or (4)(a) and regulation 18(1) of this Annex. |
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