What entries are required to be made on form ALC (NFD) 1(d)?

(2) geographical limits of the voyage or voyages (Clause (ii)); (3) country of port of final destination for terminating the agreement (Clause (ii)); (4) country where notice is to take effect (Clause (iii)); (5) period of notice in hours or days (Clause (iii)); any further provision about pay and any provision about hours of work, leave and subsistence (Clause (vi)); signature of employer, master or other person authorised by the employer with date and place.