(1) Particulars to be stated both by the salvor and by the master or other person in charge of the vessel, cargo, or property saved:—

(a) The place, condition, and circumstances in which the vessel, cargo, or property was at the time when the services were rendered for which salvage is claimed:

(b) The nature and duration of the services rendered.

(2) Additional particulars to be stated by the salvor:—

(a) The proportion of the value of the vessel, cargo, and property, and of the freight which he claims for salvage, or the values at which he estimates the vessel, freight, cargo, and property respectively, and the several amounts that he claims for salvage in respect of the same:

(b) Any other circumstances which he thinks relevant to the said claim.

(3) Additional particulars to be stated by the said master or other person in charge of the said vessel, cargo, or property:—

(a) A copy of the certificate of registry of the said vessel, and of the endorsements thereon, stating any change which (to his knowledge or belief) has occurred in the particulars contained in the certificate; and stating also to the best of his knowledge and belief, the state of the title to the vessel for the time being, and of the incumbrances and certificates of mortgage or sale, if any, affecting the same, and the names and places of business of the owners and incumbrancers:

(b) The name and place of business or residence of the freighter (if any) of the said vessel, and the freight to be paid for the voyage on which she then is:

(c) A general account of the quantity and nature of the cargo at the time the salvage services were rendered:

(d) The name and place of business or residence of the owner of the cargo and of the consignee thereof:

(e) The values at which the master or person making the statement estimates the vessel, cargo, and property, and the freight respectively, or if he thinks fit, in lieu of the estimated value of the cargo, a copy of the vessel’s manifest:

(f) The amounts which the master thinks should be paid as salvage for the services rendered:

(g) An accurate list of the property saved in cases where the vessel is not saved:

(h) An account of the proceeds of the sale of the vessel, cargo, or property, in cases where the same or any of them are sold at the port where the statement is made:

(i) The number, capacities, and condition of the crew of the vessel at the time when the services were rendered; and

(k) Any other circumstances he thinks relevant to the matters in question.

PART II.

Salvage Bond.

[N.B.—Any of the Particulars not known, or not required, by reason of the Claim being only against the Cargo, &c., may be omitted.]

Whereas certain salvage services are alleged to have been rendered by the vessel [insert names of vessel and of commander], commander, to the merchant vessel [insert names of vessel and master], master, belonging to [name and place of business or residence of owner of vessel], freighted by [the same of the freighter], and to tie cargo therein, consisting of [state very shortly the descriptions and quantities of the goods, and the names and addresses of their owners and consignees]:

And whereas the said vessel and cargo have been brought into the port of [insert name and situation of port], and a statement of the salvage claim has been sent to [insert the name of the consular officer or judge of the Colonial Court of Admiralty or Vice-Admiralty Court and of the office he fills], and he has fixed the amount to be inserted in this bond at the sum of [state the sum].

Now I, the said [master ’ s name], do hereby, in pursuance of the Merchant Shipping Act, 1894, bind the several owners for the time being of the said vessel and of the cargo therein and of the freight payable in respect of that cargo and their respective heirs, executors, and administrators, to pay among them such sum not exceeding the said sum of [state the sum fixed], in such proportions and to such persons as [if the parties agree on any other court, substitute the name of it here], the High Court in England shall adjudge to be payable as salvage for the services so alleged to have been rendered as aforesaid.

In witness whereof I have hereunto set my hand and seal, this [insert the date] day of

Signed, sealed, and delivered by the said [master ’ s name].

(l.s.)

In the presence of [name of consular officer or judge of the Colonial Court of Admiralty or Vice-Admiralty Court, and of the office hefills.]