Dear Paricipants,

We believe that you have been to Indonesia before, thank you for visiting Indonesia again.

The WONDERFUL WEST SUMATERA RALLY 2020 is a new rally passage and also the passage that will be completing the whole Indonesian Passage for Visiting Yacht.

General info of the rally

Entry Point Sabang – Weh IslandEntry Date 15 March 2020Destinations 14 destinationsExit Point NatunaExit Date Will be Matched to SMPTEDuration More than 100 days

Supported by Ministry of Tourism of IndonesiaLocal GovermentThe People

Organized by Raymond T. LesmanaEntry Fee USD 200Payment Bank TransferBank Acc# BNI

Acct. No. 0127440278 Swift Code BNINIDJA

Bank Address Jl. H. Agus Salim No.44 Jakarta Pusat. DKI – Jakarta Indonesia

Beneficiary: Raymond Timotius Lesmana Address: Perum Nuansa Kori XVI/1 Ubung Kaja - Denpasar Utara, BALI Indonesia

Latest Registration 05 March 2020

REGISTRATION FORMBoat Data:

Boat name : SV...............................Flag :Skipper - Owner NameNationality :

Visiting DataPurpose of Visit : TourismApp. Entry Date : ........ /.............. / 20.....Entry Point :Country before Entry :Plan to visit for : ....... month/sExit Point :Country after Exit :App. Exit Date : ........ / ................ / ........

AIS No. : …………………………..

Boat Information:Boat type : Mono Hull/ Ctamaran/ Trimaran/ OthersGross tonnage : .... GRTNet Tonnage : ... NRTLength : .....Ft./m’Beam : .....Ft./m’Draft : .... Ft./m’

Other – Request or Information :

This Data is prepared for my Agent – to prepare the necessary documents for our visit to Indonesia

Agent Name : Raymond T. LesmanaPhone : +62 811124574Email : raymond@sailtoindonesia.com

SV. .............................

Captain.

WEST SUMATERA RALLY 2020

DECLARATION LETTERSV. .............................

To whom it may concerrns:

Complying to the Indonesian Custom Regulation – in term of Import and re-exporting of my boat during my visit to Indonesia, I am declaring as follows :

Name :

Passport No. :

Status : Captain/ Owner

Address : SV.

Email/ Call Sign:

Declaring that the present boat price is USD. .............

And I am also declaring that during my visit to Indonesia – I will not use my boat for commerial purposes and have no intention to sell my boat.

We will comply with Indonesian Custom Regulation in term of Temporarily Importing and Re- Exporting my boat before exiting Indonesia

Should I have not comply with the Indonesian Custom Regulation – I understand that I will be charged according to the Indonesian Custom Regulation.

Signed atDateSincerely,

Captain/ OwnerSV. .....................

CREW LISTBoat Name : SVCall Sign :Nationality Boat Flag :Captain name :

No. Name M/F Nationality Passport No. Expire Date 1 Captain2 Crew3 Crew4 Crew5 Crew6 Crew

Date,

(signed please)

-...Captain Name...-SV. .........................

:

Tanggal :A. DATA-DATA KAPAL WISATA / DETAILS OF CRUISING YACHT

1. Nama Kapal Wisata Name of Yacht

5. Berat Kotor Gross Tonage

2. Kebangsaan

6. Panjang Keseluruhan Length Over All

3. Nama Panggilan Call Sign

7. Nama Nakhoda Name of Captain

4. Nomor AIS AIS Number

8. Nama Pemilik Name of owner

B. URAIAN DARI PENJAMIN ATAU AGEN / DETAILS OF GUARANTEE OR AGENT1. Nama Perusahaan

Name of Company2. Nama Penanggung jawab

Name of Person Incharge3. Alamat Perusahaan

Address of CompanyC. KETERANGAN LENGKAP AWAK KAPAL DAN PENUMPANG / DETAILS OF CREW AND PASSENGERSNo Nama

NameKebangsaan Nationality

Jabatan Position

Tempat dan TanggalTurun Place & Date Sign Off

1.2.3.4.

D. URAIAN RENCANA PERJALANAN / DETAILS OF ITINERARIES1. Nama Pelabuhan Asal

Name of Origin Port Tanggal berangkat Date of Departure

3. Nama dan Pelabuhan Keluar Name of Exit Port

Tanggal berangkat2. Nama Pelabuhan Masuk

Name of Port of Entry Tanggal dan jam tiba Date and time of arrival

4. Nama Pelabuhan Tujuan Name of Destination Port Tanggal tiba

E. DAFTAR PELABUHAN YANG AKAN DISINGGAHI / LIST OF PORT INTENDED TO VISITNo Nama Pelabuhan / Name of Ports Urutan Rute

/ RouteTgl Tiba ETA

Tgl Tolak ETD

1. Pelabuhan Sabang, Aceh2. Pelabuhan Belawan, Medan, Sumatera Utara

3. Pelabuhan Teluk Bayur, Sumatera Barat4. Nongsa Point Marina, Batam, Kep Riau5. Bandar Bintan Telani, Bintan, Kep. Riau6. Pelabuhan Tanjung Pandan, Belitung, Bangka

7. Pelabuhan Sunda Kelapa & Marina Ancol, DKI Jakarta8. Pelabuhan Benoa, Badung, Bali9. Pelabuhan Tenau, Kupang, Nusa Tenggara Timur

10. Pelabuhan Kumai, Kotawaringin Barat, Kalimantan Tengah11. Pelabuhan Tarakan, Tarakan, Kalimantan Utara12. Pelabuhan Nunukan, Bulungan, Kalimantan Timur13. Pelabuhan Bitung, Bitung, Sulawesi Utara14. Pelabuhan Ambon, Ambon, Maluku15. Pelabuhan Saumlaki, Maluku Tenggara Barat, Maluku16. Pelabuhan Tual, Maluku Tenggara, Maluku17. Pelabuhan Sorong, Sorong, Papua Barat18. Pelabuhan Biak, Biak, Papua19. Pelabuhan Tarempa, Anambas20. Lombok Utara21. Lombok Barat

Tempat dan Tanggal / Place and DateCaptain signature Agent signature

CAPTAIN PERSONAL DATA

BOAT NAME : ……………………………………………………….

CAPTAIN NAME :…………………………………………………………

HOME ADDRESS : ………………………………………………………..

………………………………………………………..

………………………………………………………..

CAPTAIN’S PHONE NO. : ………………………………………………………..

CAPTAIN’S EMAIL : ……………………………………………………….. (This Email will be used for communication)

A.I.S NUMBER : ……………………………………………………….(must have an AIS while visiting Indonesia)

CALL SIGN NUMBER : ………………………………………………………..

PLEASE BE ADVISE THAT YOU HAVE TO TURN YOUR AIS ON EVERYDAY WHILE YOU ARE SAILING IN INDONESIAN WATER – OR AT LEAST TWICE A DAY – MORNING AND

AFTERNOON.

DRUG LIST

DRUG LIST – PLEASE LIST THE DRUG YOU CARRY ON THE BOAT

NAME Q’TY EXPIRE DATE PURPOSE/ NOTE

Please also attach copy of:

Passports from Captain and CrewsBoat RegistrationBoat Photo with name shownSkipper Photo

Send all of this info by email - please

NOTEPLEASE ALWAYS MENTIONED YOUR BOAT NAME IN EVERY EMAIL

IN THE ‘SUBJECT’ SECTION’THIS WILL HELP ME A LOT TO RECOGNIZE YOU