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MD 507

The document is a Local Vessels Entry & Clearance Declaration Form for the Hong Kong Marine Department, requiring details about the vessel, agent, and cargo. It includes a declaration regarding dangerous goods and the responsibilities of the company. Additionally, it outlines the use of personal data provided in the application form and the rights of data subjects under the Personal Data (Privacy) Ordinance.

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10 views1 page

MD 507

The document is a Local Vessels Entry & Clearance Declaration Form for the Hong Kong Marine Department, requiring details about the vessel, agent, and cargo. It includes a declaration regarding dangerous goods and the responsibilities of the company. Additionally, it outlines the use of personal data provided in the application form and the rights of data subjects under the Personal Data (Privacy) Ordinance.

Uploaded by

bb13524
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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香港特別行政區政府海事處

MARINE DEPARTMENT
THE GOVERNMENT OF THE HONG KONG SPECIAL ADMINISTRATIVE REGION
Local Vessels Entry & Clearance Declaration Form
Submit Date
(DD/MM/YYYY ): For Official Use Only
Agent : Please choose the District Marine Office for collection of the permit issued Demand Note No.
Telephone : Receipt Number:
Fax : Accept Date
Contact person :
Agent's Address : Stamp:

Name of vessel &


Advance Date Time Cargo Vessel Berthing
MD Ref. Number or MD Ref. Number / C.O.O. Number
Name of Vessel Port (24-hour clock) Location for trips
C.O.O. Number
(Note 10) Tug Boat Vessel being towed
DD/MM/YYYY HH:MM

Inbound

Inbound

Inbound

Inbound

Inbound

I/We hereby declare that (1) should DG is carried onboard the above vessel(s), the DG information is comprehensively listed out in the DG manifest provided herewith.
(2) this company undertakes to be responsible for the legal, safety and financial liabilities of the above vessel(s) and crew in Hong Kong

Total Amount of Demand Note (HK $) Provision of DG Manifest ------ Yes/No


Company Chop and Signature

******************************************************************************************************************************************************************
Personal Data Collection Statement
The personal data provided by this application form will be used by Marine Department for process licensing and port formalities purposes, and may be disclosed to other departments/agencies for
investigation/prosecution purposes. In accordance with the Personal Data (Privacy) Ordinance (Cap. 486), data subjects have a right to request access to and correction of their personal data provided in the application
form. For access to or correction of personal data in the application form, please contact the Officer-in-charge, any District Marine Office of the Marine Department.
MD 507e (Rev 2021/12) Page 1 of 1

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