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1. INSPECTOR(S) Name… Contracting Party … GFCM Identity Card number… Name… Contracting Party … GFCM Identity Card number … Name … Contracting Party … GFCM Identity Card number … 2. VESSEL CARRYING THE INSPECTOR(S) 2.1 Name and Registration … 2.2 Flag … 3. INFORMATION ON VESSEL INSPECTED 3.1 Name and Registration … 3.2 Flag … 3.3 Captain (Name and address) … 3.4 Ship owner (Name and address) … 3.5 GFCM Record number … 3.6 Type of vessel … 4. POSITION 4.1 Position as determined by inspecting vessel’s master at …UTC; Lat … Long … 4.2 Position as determined by fishing vessel’s master at …UTC; Lat … Long … 5. DATE AND TIMES THE INSPECTION COMMENCED AND FINISHED 5.1 Date … Time arrived on board … UTC – Time of Departure …UTC 6. TYPE OF FISHING GEAR ON BOARD Bottom otter trawl – OTB Mid-water otter trawl – OTM Shrimp trawls – TBS Purse seine – PS Gillnets anchored (set) – GNS Set longlines – LLS Recreational gear – RG Other (Specify) 7. MESH MEASUREMENT – IN MILLIMETRES 7.1 Legal mesh size to be used: …mm 7.2 Result of the average mesh size measurement: …mm 7.3 Infringement: YES ☐ – NO ☐… In case of YES, legal reference: 8. INSPECTION OF CATCHES ON BOARD

8.1 Results of the inspection of the fish on board SPECIES (FAO tri alpha Code) Total (Kg) Presentation Sample inspected % of fish undersize 8.2 Infringement: YES ☐ – NO ☐ … In case of YES, legal reference: 9. INSPECTION OF DOCUMENTS ON BOARD AND VMS 9.1 Fishing Log Book: YES ☐ – NO ☐ 9.2 Infringement: YES ☐ – NO ☐ … In case of YES, legal reference: 9.3 Fishing Licence: YES ☐ – NO ☐ 9.4 Infringement: YES ☐ – NO ☐ … In case of YES, legal reference: 9.5 Specific authorisation: YES ☐ – NO ☐ 9.6 Infringement: YES ☐ – NO ☐ … In case of YES, legal reference: 9.7 VMS: YES ☐ – NO ☐ … in function: YES ☐ – NO ☐ 9.8 Infringement: YES ☐ – NO ☐ … In case of YES, legal reference: 10. LIST OF VIOLATIONS ☐ Fishing without a licence, permit or authorisation issued by the flag CPC – legal reference: ☐ Failure to maintain sufficient records of catch and catch-related data in accordance with the GFCM’s reporting requirements or significant misreporting of such catch and/or catch-related data – legal reference: ☐ Fishing in a closed area – legal reference: ☐ Fishing during a closed season– legal reference: ☐ Use of prohibited fishing gear – legal reference:

☐ Falsification or intentionally concealment of the markings, identity or registration of a fishing vessel – legal reference: ☐ Concealment, tampering with or disposal of evidence relating to investigation of a violation – legal reference: ☐ Multiple violations which taken together constitute a serious disregard of measures in force pursuant to the GFCM; ☐ Assault, resistance, intimidation, sexual harassment, interference with, or undue obstruction or delay of an authorised inspector; ☐ Interference with the satellite monitoring system and/or operates without VMS system – legal reference: 11. LIST OF DOCUMENTS COPIED ON BOARD … … … … … … … … 12. COMMENTS AND SIGNATURE BY THE MASTER OF VESSEL … … … … … … … … Signature of master: … 13. COMMENTS AND SIGNATURE BY THE INSPECTOR(S) … … … … … … … … Signature of inspector(s): …