|
ANNEX 1
|
 |
THE REPUBLIC OF LIBERIA
BUREAU OF MARITIME
AFFAIRS
LIBERIAN PLEASURE AND WATERCRAFT REGISTRY |
THIS SPACE FOR OFFICIAL
USE ONLY |
|
OFFICIAL NO. |
|
|
CALL SIGN |
|
APPLICATION FOR OFFICIAL NUMBER,
CALL SIGN AND REGISTRATION OF VESSEL
PART 1. GENERAL
|
1. NEW NAME |
2. FORMER NAME |
3. FORMER COUNTRY OF
REGISTRY |
|
|
|
|
|
4. EXPECTED DATE
|OF REGISTRATION |
5. VESSEL TYPE |
6.
CLASSIFICATION SOCIETY
(vessels over 24m) |
7. NAME OF OWNER(S) |
|
|
|
|
|
|
8. RESIDENCE |
9. CITIZENSHIP |
10. PERCENTAGE |
11. BUILT BY |
| |
|
|
|
|
12. YEAR BUILT |
13. PLACE BUILT |
14. NUMBER AND
TYPE OF ENGINES |
|
|
|
|
15. LENGTH |
16. BREADTH |
17. DEPTH |
18. GROSS
TONS |
19. NET TONS |
| |
|
|
|
|
PART 2. CORRESPONDENCE
The Decision-Maker for the vessel, available on a 24-hour basis, is:
|
Name and address of
Decision-Maker |
Telephone |
|
|
Telefax |
|
|
Telex |
|
General Correspondence and Billing should be sent to the
following:
|
Name and addres |
Telephone |
|
|
Telefax |
|
|
Telex |
|
PART 3. MORTGAGE DATA
If one or more ship mortgages (or assignments thereof) are to be
recorded against the vessel, please provide as
much of the following data presently known:
|
|
FIRST PREFERRED
MORTGAGEE |
SECOND PREFERRED
MORTAGEE |
|
Name of Mortgagee |
|
|
|
Total Amount of Mortgage |
|
|
|
Discharge Amount |
|
|
|
Date of Maturity |
|
|
|
Name of Assignee |
|
|
PART 4. RADIO COMMUNICATIONS
A contract has been (or will be) entered into
with:
______________________________________________________________________
Address/ telephone Number/fax
AFFIRMATION RE SURRENDER
OF FOREIGN DOCUMENTS AND MARKINGS
The present or prospective
master is a citizen of ___________________________________
and is ordered and instructed to, upon receipt of the vessel’s Liberian
Pleasure and Small
Watercraft Certificate of Registration, surrender the vessel’s
outstanding documents issued
by the Government of
____________________________ and to make Markings required
by Section 75, Chapter 2, of
the Liberian Maritime Law, as amended.
Subscribed and Sworn before
me this ________ day of ______ (Year)_________________
at _________________________
_____________________________
Owner/ Agent/ Attorney-in-Fact
Documents to
Accompany the Application
a. Existing
Vessel: Proof of ownership is usually the Bill of Sale, Builder’s
Certificate or Master Carpenter’s
Certificate transferring title to the present owner. Three (3) copies
must be submitted for recording purposes.
b. Authority of Agent or
Officer: This document is usually submitted in the form of a Power
of Attorney, authorizing one or more named persons to act for or on
behalf of the Owner in making application for registration.
Payment should be arranged prior
processing according to submitted proforma invoice.
|