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(1) Vessel information. This includes the vessel's name, International Maritime Organization (IMO) number or other vessel identification number if an IMO number is not issued, country of registry, owner or operator, type and tonnage. (2) Voyage information. This includes the port and date of arrival, name and contact information of the person submitting the form, last port and country of call, and next port and country of call. (3) Ballast water information. This includes the vessel's total ballast water capacity, total number of ballast water tanks, total volume of ballast water onboard, total number of ballast water tanks in ballast, and the identification of ballast water management method used. (4) Information on ballast water tanks that are to be discharged into the waters of the United States or to a reception facility. Include the following for each tank discharged: (i) The numerical designation, type and capacity of the ballast tank. (ii) The source of the ballast water. This includes date(s), location(s), and volume(s). If a tank has undergone ballast water exchange, provide the loading port of the ballast water that was discharged during the exchange. (iii) The date(s), starting location(s), ending location(s), volume(s), and method(s) of ballast water management. (iv) The date(s), location(s), and volume(s) of any ballast water discharged into the waters of the United States or to a reception facility. (5) Certificate of accurate information. Include the name and title of the individual (i.e., master, owner, operator, agent, person in charge) attesting to the accuracy of the information provided and that the activities were in accordance with the ballast water management plan required by 151.2050(g). If exceptional circumstances required deviation from the plan, the details surrounding the need for deviation and associated actions must be explained.