HARBOR MOVEMENT REQUEST

This form is for Harbor Authorization Movements in the Port of Pago Pago. The ETA and ETD is a separate form for each movement for each ETA/ETD. For more information, contact us at (684) 633-4251 extension 1108, 1129, 1130, and 1131.

Full Name(*)

Please type your full name.

Agent(*)

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Vessel Name(*)

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Phone(*)

Place of Birth is required.

E-mail(*)

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VESSEL ETA

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VESSEL ETD

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INTER ISLAND DOCK

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MAIN DOCK

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NEW DOCK

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FUEL DOCK

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ANCHORAGE AREA - OUTER DOCK

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ANCHORAGE AREA - INNER DOCK

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CANNERIES - SAMOA TUNA PROCESSING DOCK

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CANNERIES - STAR KIST DOCK

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SHIPYARD DOCK / RAILWAYS

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MARINA AREA

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HARBOR MOVEMENT REVISION

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NOTE: Is this a revision of a previous movement request? If YES, please enter the most recent movement HMO-M Request ID number above. If NO, a new form must be created.

Signature(*)

Sign Above

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(*)

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