Maritime Pollution Report

Shipping Deputy Ministry

Maritime Surveillance and Anti-pollution Unit

Telephone: 25 848 202/277, FAX: 25 848 200/173, Email: vtmis@dms.gov.cy

Complete Only Applicable Items

INFORMER DETAILS

Full Name

Address

Telephone

Fax

E-mail

POLLUTION INFORMATION

Date

Time (accepted format: 00:00 am/pm)

Position and/ or Location

Distance from Shore

Dimensions (Length x Width)

Direction of Pollutants Towards Shore Towards Open Sea

POLLUTION TYPE

SUSPECTED VESSEL INFORMATION

Name

Registration Number

Type

IMO

MMSI

METEOROLOGICAL DATA

Wind Direction

Wind Speed

Additional Information:

Acceptable file formats are jpg, jpeg, mov and mp4 and the size of ALL the files TOGETHER should not exceed 10MB.

File 1: File 2: File 3:

Data Protection Statement: The information provided on this form by you to the Shipping Deputy Ministry (SDM) is required for the purposes of a maritime pollution report. When the SDM processes your personal information, for example, collects it on a form or stores it in a file or on a computer is obliged to comply with the General Data Protection Regulation (GDPR). Your personal information will not be shared or processed for any other purpose without your express consent.

Maritime Pollution Report

MARITIME POLLUTION REPORT

Contact Information