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 4RADIO 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 vesselís  Liberian Pleasure and Small
Watercraft Certificate of Registration, surrender  the vesselís 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, Builderís Certificate or Master Carpenterís
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.
 

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