Preliminary act
Form 11 Preliminary act
(paragraph 25(2)(a))
(Title)
PRELIMINARY ACT
(To be used where loss of, or damage to or by, a single ship)
Preliminary act of plaintiff/defendant1
1. Date of loss or damage:
2. Time of loss or damage:
3. Place of loss or damage:
4. Name of ship involved:
5. Description of anything else involved2:
6. If the ship involved belonged to the party filing this preliminary act:
port of registry:
the name of master at relevant time:
name and address of person in command at and immediately before the time of the loss or damage:
name and address of persons on the bridge at and immediately before the time of the loss or damage:
name and address of persons keeping a lookout at and immediately before the time of the loss or damage:
course, or, if the ship was stationary, heading (specify which) at the time when it first became known that there was a likelihood of the loss or damage or immediately before any measures where taken to avoid that loss or damage (whichever was the earlier):
speed at the earlier of the times referred to in paragraph (f):
alterations made to course after the earlier of the times referred to in paragraph (f) and before the time of the loss or damage, and when made:
alterations made to speed after the earlier of the times referred to in paragraph (f) and before the time of the loss or damage, and when made:
other measures taken to avoid the loss or damage, and when taken:
sounds or other signals given, and when given:
lights carried:
7. If the ship involved did not belong to the party filing this preliminary act and the loss or damage occurred in a collision with something else:
distance and bearing of ship at the time when its echo was first observed by radar by a person on the other thing involved in the collision:
distance, bearing and approximate heading of ship when first seen by a person on the other thing involved in the collision:
the lights that were being shown by ship when first seen by a person on the other thing involved in the collision:
the lights that were being shown by ship after that time but before the collision:
the alterations made by ship to its course after it was first seen by a person on the other thing involved in the collision, and when they were made:
the alterations made by ship to its speed after it was first seen by a person on the other thing involved in the collision, and when they were made:
the other measures taken by ship to avoid the collision, and when they were taken:
the sounds or other signals given by ship and when they were given:
8. The state of the weather at and immediately before the time of the loss or damage:
9. The extent of visibility at and immediately before the time of the loss or damage:
10. The state, direction and force of the tidal or other current at and immediately before the time of the loss or damage:
11. The direction and force of the wind at and immediately before the time of the loss or damage:
12. The parts of the ship and the other thing which first came into contact:
13. The approximate angle between the ship and the other thing at the moment of contact:
1. Complete all questions fully. If any are not applicable, say so and why.
This Act’s bill:Explanatory statement
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