Audit

Port State Measures Inspection

Inspection Report No.

Port State: New Zealand

Inspecting Authority: Ministry For Primary Industries

Name of Principal Inspector

Inspector Warrant Number

Port Of Inspection

Commencement of Inspection

Advanced notification received

Purpose

Last Port of Call

Port

State

Date

Vessel Name

Flag State

Type of Vessel

International Radio Call Sign

Certificate of Registry ID

Certificate of Registry photo

IMO Ship ID (if Available)

External ID (if Available)

Port of Registry

Vessel Owners

Vessel Beneficial Owner(s) if Known and Different to Vessel Owner

Vessel Operator(s) if Different to Vessel Owner

Vessel Master

Name

Nationality

Photo of Master and ID

Fishing Master

Name

Nationality

Photo of Fishing Master and ID

Vessel Agent

Vessel Monitoring System

Status in Regional Fisheries Management Organisations (RFMO) Areas Where Fishing or Fishing Related Activities Have Been Undertaken, Including Any Illegal Unreported Unregulated (IUU) Vessel Listing

Vessel Status

Vessel Identifier

RFMO

Flag State Status

Vessel on Authorised Vessel List

Vessel on IUU Vessel List

Relevant Fishing Authorisation(s)

Fishing Authorisation

Identifier

Issued By

Validity

Fishing Areas

Species

Gear

Relevant Transhipment Authorisation(s)

Transhipment Authorisation

Identifier

Issued By

Validity

Transhipment Information Concerning Donor Vessels

Donor Vessel

Name

Flag State

ID No

Species

Product Form

Catch Areas

Quantity

Evaluation of Offloaded Catch (quantity)

Offloaded Catch

Species

Product Form

Catch Area(s)

Quantity Declared

Quantity Offloaded

Difference Between Quantity Declared and quantity determined, if any

Catch Retained On Board

Retained On Board

Species

Product Form

Catch Area(s)

Quantity Declared

Quantity Offloaded

Difference Between Quantity Declared and quantity determined, if any

Examination of Logbook(s) and other Documentation

Compliance With Applicable Catch Documentation Scheme(s)

Compliance With Applicable Trade Information Scheme(s)

Type of Gear Used

Gear Examined in Accordance With Paragraph e of Annex B

Seabird Mitigation Devices on Board

Findings

Apparent Infringement(s) Noted Including Reference to Relevant Legal Instrument(s)

Comments by the Master

Action Taken

Master's Signature
Inspector's Signature
Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.