1. Name of Expedition Organizer
(Company, entity, or person(s) as appropriate)
2. Expedition Organizer's Contact Person
A. Expedition Organizer
3. Mailing Address (Please also provide physical address if using a post office box) 4. Nationality of Expedition Organizer
5. Principal Place of Business (Home office) 6. Total Number of Expedition Staff per Excursion
7. International Phone 8. International Fax
ADVANCE NOTIFICATION FORM
U.S. Department of State
DS-4131
07-2017
This information is requested in furtherance of U.S. obligations under Article VII(5)(a) of the Antarctic Treaty of 1959, and consistent
with Antarctic Treaty Consultative Meeting Recommendation XVIII-1 and Resolution XIX-3. Information below should be submitted no
later than three months prior to intended travel to the Antarctic Treaty Area. Responses will facilitate a determination of U.S.
jurisdiction over the activity and permit timely dissemination to Parties to the Treaty of expedition details. Certain expedition
information may be posted on the National Science Foundation’s and the Antarctic Treaty Secretariat's Web sites in order to facilitate
notification of and access by all Parties to the Treaty. All U.S. nationals organizing expeditions to Antarctica in the United States, or
proceeding to Antarctica from the United States, should submit this form to the U.S. Department of State as indicated below . In
addition to disclosure to other Parties to the Treaty, the information provided may be shared with the U.S. Environmental Protection
Agency to ensure compliance with 40 CFR (Code of Federal Regulations) Part 8, Environmental Impact Assessment (EIA) of
Nongovernmental Activities in Antarctica, as well as with other relevant U.S. agencies. The information also may be shared with
appropriate domestic or foreign entities for law enforcement, search and rescue, or administrative purposes.
Include attachments for responses that require more space than the form provides. If an organizer is planning more than one
expedition, details specific to each individual expedition should be provided as attachments to this form. Each organizer should
prepare only one Advance Notification form.
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9. Explain activities undertaken by the organizer, including, for example, acquiring the use of vessels or aircraft, hiring expedition staff, or planning
itineraries.
TOURIST AND OTHER NON-GOVERNMENTAL ACTIVITIES IN THE ANTARCTIC TREATY AREA
11. Explain whether any organizing activities will be or are being performed by a party or parties other than the named expedition organizer; e.g., a
sub-charter. Identify the nationality of individuals or commercial entities to whom the expedition organizer has delegated specified organizational
responsibilities.
10. Explain if the organizer maintains substantial ties to a country or countries other than the United States; for example, a U.S. national who habitually
resides in another country, or a company which is the subsidiary of an entity incorporated in or with other substantial ties to another country.
12. Describe where the organizing activities conducted prior to the expedition will be or are being performed.
13. Specify the place(s) from which the expedition(s) will depart immediately prior to entering the Treaty Area.
OMB APPROVAL NO. 1405-0181
EXPIRES: 05/31/2021
ESTIMATED BURDEN: 10.5 HOURS
The completed form should be submitted to the Antarctic Advisor, Office of Ocean and Polar Affairs, Bureau of Oceans,
Environment and Science, U.S. Department of State, 2201 C Street NW, Washington DC 20520.
NOTE: For the purposes of this form, "expeditions to Antarctica" include activities south of Sixty degrees South Latitude, excluding
commercial fishing voyages. Crew includes an expedition’s captain and officers, helicopter pilots, and deck, engine, and
hotel/catering staff. Expedition staff include guides, lecturers, and small boat drivers who are not otherwise counted as crew.
Passengers include other persons accompanying the expedition, but exclude national representatives or observers.
