ANNEX C

REPORT OF COURT OF MARINE ENQUIRY

(Regulation 21)

In the matter of a formal investigation by a Court of Marine Enquiry held at

............................................................... on the ..................................... (here state all the days

on which the Court sat) ................................................................................................... before

......................................., Presiding Officer, and ................................................................. and

......................................................................., Members, into the circumstances attending the

................................................... (here state briefly the substance of the allegation or describe

the event for the investigation of which the Court was convened) .............................................

..................................................................................................................................................

The Court, having carefully inquired into the circumstances attending the matter to be

investigated, finds for the reasons stated in the Appendix hereto, that the ................................

(here state the finding of the Court) ...........................................................................................

Dated at ........................................ this ...............day of .......................... 20...........

..............................................

Presiding Officer

We (or I) concur in the above report.

.............................................

Member

.............................................

Member

APPENDIX TO THE REPORT

(Here state fully the circumstances of the case, the opinion of the Court touching the truth of the allegation or the causes of the event and the conduct of any persons implicated therein, and whether the certificate of any officer has been either suspended or cancelled, and the reasons for the said opinion, and if the certificates of any officer has been suspended or cancelled the reasons for such suspension or cancellation.)

[Annex C substituted by regulation 18 of Notice No. R. 777 dated 5 August 2005]