U.S.

Voyage Quarterly Declaration

PLEASE READ NOTES OVERLEAF BEFORE COMPLETING THIS FORM
Period
From
To
During the above quarter have any tank ships owned / operated by yourselves and entered in this club loaded and / or
discharged at any port or area in the United States E.E.Z. as defined under note 1 overleaf?
YES
NO
Please tick appropriate box and if YES please provide details below of every cargo voyage to or from the U.S. E.E.Z.
Ship name
Gross tonnage
Date loaded

Date discharged

Location of loading (please delete as appropriate)

Loop / offshore transfer / port

If port please provide port name:

Location of discharge (please delete as appropriate)

Loop / offshore transfer / port

If port please provide port name:

Cargo type (please delete as appropriate)

Persistent / non persistent

If non persistent please provide exact cargo description

Is the ship a parcel tanker? (see note 6 overleaf)

Yes / no

If yes then please state quantity of persistent cargo carries (if any)

Tons

Is the ship equipped with segregated ballast tanks and was this voyage carried
out in SBT mode? (see note 7 overleaf)

Yes / no

Ship name

Gross tonnage

Date loaded

Date discharged

Location of loading (please delete as appropriate)

Loop / offshore transfer / port

If port please provide port name:

Location of discharge (please delete as appropriate)

Loop / offshore transfer / port

If port please provide port name:

Cargo type (please delete as appropriate)

Persistent / non persistent

If non persistent please provide exact cargo description

Is the ship a parcel tanker? (see note 6 overleaf)

Yes / no

If yes then please state quantity of persistent cargo carries (if any)

Tons

Is the ship equipped with segregated ballast tanks and was this voyage carried
out in SBT mode? (see note 7 overleaf)

Yes / no

Ship name

Gross tonnage

Date loaded

Date discharged

Location of loading (please delete as appropriate)

Loop / offshore transfer / port

If port please provide port name:

Location of discharge (please delete as appropriate)

Loop / offshore transfer / port

If port please provide port name:

Cargo type (please delete as appropriate)

Persistent / non persistent

If non persistent please provide exact cargo description

Is the ship a parcel tanker? (see note 6 overleaf)

Yes / no

If yes then please state quantity of persistent cargo carries (if any)

Tons

Is the ship equipped with segregated ballast tanks and was this voyage carried
out in SBT mode? (see note 7 overleaf)

Yes / no

Name of owner..
Owners authorised signatory..
Please return this form to the managers London Agents within 2 months of the end of each quarter.
The Managers London Agents: Charles Taylor & Co. Limited
Registered in England No.2561548 Registered office: Standard House, 12/13 Essex Street, London WC2R 3AA
Telephone: +44 20 3320 8888 Fax: +44 20 3320 8800 E-mail: p&i.london@ctcplc.com
Charles Taylor & Co. Limited is an appointed representative of Charles Taylor Consulting plc,
which is authorised and regulated by the UK Financial Services Authority
1

INSTRUCTIONS FOR COMPLETION OF U.S. VOYAGE QUARTERLY DECLARATIONS

1.

U.S. Voyage is any cargo voyage involving loading or discharging cargo at any port or place in the United States
of America or within the Exclusive Economic Zone (EEZ) as defined in the Oil Pollution Act 1990. The USA
includes District of Columbia, Puerto Rico, Guam, American Samoa, U.S. Virgin Islands and Northern Marianas.

2.

Date of loading / discharging. Loading or discharging a cargo at more than one port or place in the U.S.A. or within
the U.S. EEZ shall be regarded as a single voyage, However, both loading and discharging at a port or place is
regarded as two separate voyages.

3.

If the ship loads / discharges solely at LOOP or solely ship-to-ship transfer at a location approved by the United
States Coastguard then please specify LOOP or Offshore Transfer in the box provided.

4.

For the purposes of this declaration non persistent oil shall be defined as follows:a)

at least 50% of which, by volume, distils at a temperature of 340 degrees Celsius and

b)

at least 95% of which distils at a temperature of 370 degrees Celsius when tested by the ASTM Method
D86/78 or any subsequent revision thereof

All other hydro-carbon mineral oils are persistent.

If you have not carried persistent oils please specify the exact description of the cargo carried.
For guidance, the following oils are classed as non persistent:LNG
LPG
Alkyl C9-C14 Benzenes
Animal / Vegetable Oils
Drilling Oil LVT200/200C
Gasolines (AVGAS/MOGAS)
Polybutene
Mineral Spirits (excepting Pegasol R-100)
White Spirit
Gasoline blending components (Napthas)
Semtol 40
Kerosenes (Domestic, Tractor, Aviation, No. 1 Fuel)
Distillates (Light/Medium Gas Oil, Heating Oil, Auto Diesel 1D & 2D (No. 2 Fuel Oil is Gas Oil and classification
therefore varies)
The following oils are classed as persistent oils:Alkyl C15-C17 Benzenes
Lub oil and Lub additives
Mineral Oils
Paraffin Wax, BR/BAYONN
Mineral Spirit Pegasol R-100
Gas Oil (Heavy/Vacuum (also referred to as Virgin), Wash Gas Oil, if used to flush persistent oil, No. 3-6 Fuel Oil,
No. 2 Fuel Oil dependent upon classification)
This list is not exhaustive
5.

For ships under 3,000 g.t. or less individual voyages need not be declared. However, quarterly declarations are
still required which should indicate:a)

if trading to U.S. Ports or within the U.S. EEZ at any time during the year. Enter U.S. trading or no U.S.
trading, as appropriate.

b)

whether carrying persistent oils at any time during the quarter. Enter Persistent or Non Persistent, as
appropriate. If you have not carried persistent oils please specify the exact cargo description.

6.

If the ship is defined as a Parcel Tanker under the terms of the clubs Circular No. 1992/1 then this should be
specified in the box provided and Members should state the quantity of persistent cargo carried on each voyage.
You should also submit to the club a copy of the International Certificate of Fitness For the Carriage of Dangerous
Chemicals in Bulk with the first declaration for any such ship.

7.

If the ship is equipped with segregated ballast tanks (SBT) and the voyage in question is undertaken in SBT mode
then this should be stated. To qualify for the SBT category a tanker must be equipped with segregated ballast
tanks in accordance with the requirements of Regulation 13 of Annex 1 to MARPOL 73/78