QUARANTINE

OFFICIAL USE ADVANCE NOTIFICATION/INWARD ONLY

REPORT FOR YACHTS/SMALL CRAFT Rotation Number Form C2-C

1. REGISTRATION DETAILS

Craft name: Country of registration: Port of registration: Registration number:

Call sign: Name of person in charge: Total number of persons onboard:

Date of registration: Sail Number: Home Port:

2. ADVANCE INFORMATION OF ARRIVAL (To be filled by the master)

Estimated date of arrival: Estimated time of arrival:

Port of arrival: Port of departure: Departure date:

3. ARRIVAL DETAILS (This portion only is to be completed by the proper Officer)

Port of arrival: Date of arrival: Time of arrival:

Port arrived from: Estimated period of stay in Fiji:

4. LIST TEN (10) PORTS OF CALL – (Please list in sequence, latest port first)

1. 6.

2. 7.

3. 8.

4. 9.

5. 10.

5. FIREARMS (Specify makes, models & serial numbers)

Yes No

6. CONTROLLED DRUGS/MEDICINES ON BOARD (Name & Quantity)

Yes No

7. CURRENCY REPORT

AMOUNT CURRENCY OTHERS

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8. STORES ON BOARD Beer: Quantity:

Wine: Quantity:

Spirits: Quantity:

Cigarettes/Tobacco: Quantity:

9. NEXT OVERSEAS PORTS

Next overseas Port Expected date of departure 1.

2.

3.

10. CRAFT STATUS (Tick box that applies) Visiting Overseas Craft Returning Fiji registered Returning permanently Permanently importing craft

craft: imported craft: to Fiji:

Built in Fiji: yes no

Original import SAD

Duty Paid: yes no number:

Please attach photo of Yacht Please attach Passport Bio Data page of Master

Note: if photo cannot be attached on space provided, please Note: if photo cannot be attached on space provided, please send photo as attachment to this Inward Form. send photo as attachment to this Inward Form.

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11. CRAFT DETAILS

Craft Type: Design: Hull Design:

Yacht Motor Launch Mono CatamaranTri-maran

Other (Specify) Other (Specify

Yacht Rig: Mast Construction:

Cutter Sloop Ketch Yawl Schooner Alloy Timber Composite

Other (Specify) Other (Specify)

Hull Construction:

Steel Alloy Ferro Cement Fiberglass Composite Other (Specify)

Length: Beam: Draught: Gross Tonnage:

Metres Feet Metres Feet Metres Feet

Value of the Yacht:

(In US Currency)

12. COLOURS

Mast: Deckhouse/Superstructure (Tops):

Hull (Above waterline): Deckhouse/Superstructure (Side):

Hull (Below waterline): Decks:

Dodgers/Sail covers: Sails :

13. ENGINE

Make: Model:

Power (HP/Kw): Passage speed under motor:

Fuel capacity: Fuel consumption rate:

14. ELECTRONICS

SSB Radio Make: Model: Call sign:

VHF Radio Make: Model: Call sign:

HAM Radio Make : Model: Call sign:

Cell phone Make: Model: Number:

15. RADIO SCHEDULES MAINTAINED

Frequencies: Times: Shore station:

16. LIST OF PORTS/PLACES/ISLANDS INTEND TO VISIT WHILE IN FIJI If you intent to sail within Fiji please complete the following. It is not acceptable to say ‘outlying islands’. NAME OF ISLANDS Do you intent to go ashore? State detail reasons for visiting islands. 1.

2.

3.

4.

5.

6.

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17. CREW DETAILS (Person in charge first)

A total of ………. crews and ………. Passengers are travelling on this yacht.

Names in block letters Attach any additional details of crew members on a

separate sheet.

Surname : Surname:

First name (s): First name (s):

Nationality: Nationality:

Date of birth: Gender: M F Date of birth: Gender: M F

Passport number: Passport number:

Country of passport issued: Country of passport issued:

Overseas contact address: Overseas contact address:

Next of kin, relationship: Next of kin, relationship:

Address/telephone of next of kin: Address/telephone of next of kin:

Surname: Surname:

First name (s): First name (s):

Nationality: Nationality:

Date of birth: Gender: M F Date of birth: Gender: M F

Passport number: Passport number:

Overseas contact address: Overseas contact address:

Next of kin, relationship: Next of kin, relationship:

Address/telephone of next of kin: Address/telephone of next of kin:

18. OTHER EQUIPMENT

Life raft Make : Model: Capacity:

Dinghy/Tender Make : Model: Length:

Type: Capacity: Colour:

Outboard motor Make: Model: Power (HP/Kw):

Flares:

Parachute Hand held Smoke other (Specify)

ANY OTHER IDENTIFYING FEATURES ……………………………………………………………………………………………………………………………………..

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19. QUARANTINE PRE ARRIVAL ADVICE

1. Has any person(s) died onboard during the current voyage?

Yes

No

2. Has any person(s) become ill or shown symptoms of illness onboard during the current voyage? Yes No

(a) How many person(s) are reported ill?

(b) Which symptoms below have they displayed?

Fever

Coughing

Severe Vomiting

Rash

Profuse Diarrhoea

(Any conditions due to an injury, sea travel or any existing physical condition may not be reported)

3. During the last 50 days of your voyage, did your vessel visit or call in to Vanuatu, the Solomon Islands or Papua New

Guinea, or any port or place in Australia north of the latitude of Brisbane, or the Panama Canal, the East Indies or Asia or any port or place in which malaria carrying mosquitoes are present?

Yes No If (Yes), please name the Port and date visited. Port

Date Visited

4. Do you wish to discharge waste in port?

Yes

No

(A copy of the 50 day movement of the vessel must be submitted with this form)

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20. BIOSECURITY DECLARATION. PROHIBITED & RESTRICTED BIOSECURITY MATERIALS

COMMODITY LOCATION ORIGIN SAFEGUARD

Strictly for Vessel Use Only

No crew is allowed to take

ashore any food

Unless approval is given by

a BioSecurity Inspector

SAFEGUARD NOTICE: I agree to the following items being retained on board while the vessel is in Fiji waters unless prior approval for unloading, under the supervision of BioSecurity Inspector is obtained.

Fruits, vegetables, meat, ships palnt such as furnishing; all hay straw, rice hulls & mator ropes, ship garbage & dunnage or any plant & animal product.

NOTE: All ships garbage must be kept in covered; leak proof containers inside ships railings.

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21. ANIMAL BONDING

By this bond, I……………………….. of ………………………of the vessel…………………….. (herein called the “master”) acknowledge myself bound to THE REPUBLIC OF FIJI (herein called the government) in the sum oof ONE THOUSAND AND FIVE HUNDRED DOLLARS AND NINETY EIGHT CENTS ($1500.98) to be paid to the said Authority (Buisecurity of Fiji).

Given under my hand this…………………day of ……………..20…….

WHERE AS:

1. The said vessel “…………….is at present in Fiji water and is to remain in such water for

…………days/weeks/months. 2. The said vessel is carrying on board an animal to with, a……………. for use on the said vessel.

Description of animal

BREED SEX AGE COLOUR ORIGIN VERT.CERT.

3. Master has been required by the Authority to furnish security for his compliance with the provision of

the BIOSECURITY PROMULGATION 2008 and by this BOND has undertaken to do so. 4. The master shall not allow the said animal to leave the vessel but shall keep it on board in such

secure manner as may be approved by an inspector. 5. The master shall not allow any dog or any other animal to go or be taken on board or come into

contact with the said animal. 6. The master shall be informed and is aware that any contravention by him of the said regulation may render

the said animal liable to be seized and destroyed and without prejudice to his liability under this BOND.

NOW THE ABOVE MENTIONED BOND is considered to be void in case if within the period during which the said vessel is territorial waters of the republic of Fiji. there is full compliance by the master with BIOSECURITY PROMULGATION 2008

Attach Photo of animal

SIGNED by the said master

…………………………… …………………………………………

In the presence Biosecurity officer (Signature & stamp)

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22. MASTER’S DECLARATION I ………………………………………………… Master/Owner of the yacht ________________being the person in charge declare that all particulars stated in this Advance Notification/Inward Report are true and correct and that the yacht shall not be engaged in any way for conveying goods and or passengers for hire whilst in Fiji waters. I hereby declare that I have in my possession funds totaling to $................................ and that I will be responsible for all members of my yacht during our stay in Fiji and for their repatriation should it become necessary. I further declare that I will not allow any member to leave the yacht and will not take on any new member as permanent crew on the yacht unless I first obtained necessary clearance from an Immigration Officer. I have familiarized myself with all the Customs, Health and Biosecurity conditions and will abide by all the requirements whilst staying in Fiji.

Signature of Master/Owner: ……………………………………….. Date: ……………..

You are hereby advised that the information on this form is collected for the purpose of Customs/Health/Biosecurity clearance, monitoring the movement of the vessel and persons and border security. You must provide all information requested on the form. Failure to do so is an offence. The Fiji Authorities pursuant to the Customs Act & Regulation of 1986, Quarantine Act CAP 112, Quarantine (Amendments) Regulations 2010, Biosecurity Promulgation 2008 and the Immigration Act will hold the information you provide. 23. FOR OFFICIAL USE

1. Radio pratique issued? Yes No

2. Type of Boarding. A.M.S A.M.I M.I

3. Number of Officers to attend.

4. Where the vessel will be boarded. Pilot Station Boarding Quarantine Ground

Alongside

5.

Declared before ……………………………….. (Officers name) this ……… day of …………………… ….. 20……

Signature/Stamp of Officer

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24. INFORMATION RELATED TO FEES & CHARGES CUSTOMS Customs Special Attendance Fee Customs normal working hours are from Mon-Thursday (0800 – 1300 and 1400 – 1630 hours) Friday (0800 – 1300 and 1400 – 1600 hours) and any clearance done outside these working hours are subject to the following: Any Clearance done between 1630hrs to 2000hrs (Monday – Friday) – FJD$25.00/hr

Any Clearance done between 2000hrs to 0600hrs (Monday – Friday) – FJD$75.00

Any Clearance done between 1300hrs to 1400hrs (Monday – Friday) – FJD$25.00

Any Clearance done on Weekends and Public Holidays – FJD$105.00

HEALTH QUARANTINE ACT (CAP, 112) Quarantine (Amendment) Regulations 2010 FEES SCHEDULE FOR YACHTS Part 1, Section 3, subsection 3(e) & (f)

Clearance - FJD$100.00 Issue of Certificate of Pratique - FJD$50.00

*the above fees are Vat exclusive hence will be charged according to current Vat. BIOSECURITY (Biosecurity Promulgation 2008) CATERGORY 1: IMPORTS RISK ANALYSIS

C1-19- Refundable bond for animals quarantined on board vessels.- VIP FJD$1,500.98 C1-23-Monitoring and inspection of bonded animals on board vessels -VIP FJD$28.72 For payment of bond refund:

*A written notice of request for payment of refund is to be submitted to the Authority one week before departure to allow for processing) CATERGORY 2: IMPORTS C2-19 –Inspection of foreign garbage and supervision of incineration during normal working hours – VIP

FJD$112.13

C2-20- Inspection of foreign garbage and supervision of incineration after hours – VIP FJD$174.92

CATEGORY 4: CONVEYANCE CLEARANCE OF VESSELS C4-3- boarding and clearance of super yachts during normal working hours - per vessel- VIP- FJD$ 193-20.

C4-4 boarding and clearance of super yachts after hours- per vessel- VIP- FJD$ 487-60.

C4-5 boarding and clearance of yachts during normal working hours - per vessel- VIP - FJD$ 89-70.

C4-6 boarding and clearance of yachts after hours - per vessel- FJD$ 182-39.

[Working Hours: Monday- Friday: 0800hrs-1700hrs] [After hours: Monday to Friday-1700-0800hrs; Weekends and Public Holiday.]

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