1.船舶经纪人:____________________________
2.地点和日期:____________________________
3.船东(出租人)/营业地点:____________________________
4.租船人/营业地点:____________________________
5.船名(第8条):____________________________
6.船旗国和登记国(第8条):____________________________
7.呼号:____________________________
8.船型(内燃或蒸汽机船、干货船、油轮、冷藏船或客船):______________________
9.总登记吨位/净登记吨位:____________________________
10.建造时间/建造地点:____________________________
11.总载重吨位(约计)按夏季舷及长吨计算:____________________________
12.船级(第8条):____________________________