Rebate Request Form
(Please fill in the form and submit)

Date:
From:
To: Suez Canal Authority
Attn: Director of Transit

1. VESSEL'S PARTICULARS:
Name:
Type:
Ex. Name/s:
Call sign:
Year Built:
Dwt:
SCNT:
Last Transit Date:
Capacity in Cu. M (for LPG & LNG):
Capacity in Cu. Ft (for reefer):
Max draft:
Transit draft:
Beam:
Design speed (IFO):
Design fuel consumption (IFO):
Design fuel consumption (DO):
Cargo kind:
Cargo quantity:
TPI of TPC:

2. VOYAGE CALCULATION:
Actual speed:
Last port of origin:
First port of destination:
Distance in N. miles via Suez:
Distance in N. miles via Cape or Panama:
Difference in distance:
Weather conditions in days via Suez:
Weather conditions in days via Cape or Panama:
Duration in days via Suez:
Duration in days via Cape or Panama:
Bunkering ports:
Daily bunker consumption (IFO):
Daily bunker consumption (DO):
Daily bunker price (IFO):
Daily bunker price (DO):
Daily time charter: $
Suez canal tolls: $
Other charges: $
Panama tolls: $
Other charges: $
Cargo intake via Suez (Ton):
Cargo intake via Cape (Ton):
Freight per ton: $
Cargo lost value: $
Total cost via Suez: $
Total cost via Cape or Panama: $
Difference in cost: $
Suggested rebate (%):
Date of sailing:
Date of E.T.A. deviation:
Date of E.T.A. Suez Canal:
Remarks: