©If the report contains information demanding a 

 security classification, it should be so indi- 

 cated in this space. Ref. Navy Regulations 75^. 



{2. J Or ship, or office, where report was prepared. 



® 



Title of reporting official. 



©Official number as given in Ships' Data Book 

 Do not use accounting numbers. Special cases: 

 USCG; WR401; etc. 



® 



If ship is unnamed, leave blank. 



®If preparation of report has been delayed, check 

 this date. 



® 



. If not supplied by ship on form N.B.S.223a, con- 

 .L/ suit copy of last undocking report. 



©Calculate from dates of present docking and last 

 undocking. See Table 1. 



9) From docking plans. 



10) Leave blank for use of Bureau of Ships 



® 



To be supplied by ship on form N.B.S.223a. No 



decimals . 



®To be supplied by ship on form N.B.S.223a. See 

 instructions on pages 22 and 25. 



34 



