MARINE NOTE OF PROTEST
On this …….day of …………….20……., personally appeared and presented himself before me ……. (insert name of master), Master of the …… (insert name of vessel) of … (insert port of registry), official no:………..and ……..Net Tons, which sailed from ……….. on or about the ……. (insert date) in ballast / with cargo of …..insert brief description of cargo if any ) bound for …….( insert destination port), and arrived at port of …….on (insert date) and declare that during the voyage having experienced a collision with the ……..( insert name of colliding vessel) at about …….hrs on …..(insert date of collision) in ……..(insert general location of collision, e.g “ in the south china sea “ or “ in the Singapore Western working anchorage”) and fearing damage to the vessel’s hull rigging, machinery and / or cargo, he hereby Notes his Protest against all claim, losses, damage etc reserving the right to extend the same at time and place convenient.
Sworn and sign before me …..Captain (insert name Master).
At ………. Notary Public.
Notes:
This sample is using in collision, for other accident, pls change the word collision with actually happen. E.g: stranded, fire.
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