Download "Form: application bareboat charter registration and

Download "Form: application bareboat charter registration and

Application Bareboat charter registration and bareboat certificate of registry With this form, you can apply for the registration of a seagoing vess...

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Application

Bareboat charter registration and bareboat certificate of registry

With this form, you can apply for the registration of a seagoing vessel in the bareboat charter registry and/or request the issuance of a certificate of registry. Incompletely or inaccurately completed forms (including failing to send along the requested appendices) will not be processed.

Incomplete forms or incorrectly completed forms (including not sending the requested appendices) will not be processed. Send the form to Postbus 16191, 2500 BD Den Haag or to the following mail address: [email protected] More information +31 (0)88 489 00 00 | www.ilent.nl

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Details of applicant

1.1 (Company) name

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1.2 Chamber of Commerce number

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1.3 Business address

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1.4 Postcode and place

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1.5 Name of contact person

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1.6 Telephone number(s)

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1.7 E-mail address

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1.8 Correspondence address

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1.9 Postcode and place

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2

Details of debtor > Only complete when the invoice is not paid by the applicant

2.1 (Company) name

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2.2 Chamber of Commerce number

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2.3 Address

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2.4 Postcode and place

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3

Reason for application

3.1 What is the reason for the application?

n New registration n Registration change n Registration renewal

To be completed by the Human Environment and Transport Inspectorate Datum binnenkomst APR Registratienummer ID-nummer

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| | ILT.109E.02 | 1 of 4

Application 4

Bareboat registration and certificate of merchant shipping Human Environment and Transport Inspectorate Ministery of Infrastructure and the Environment



Required documents

4.1 Which document do you request?

n Provisional certificate of registry (ship does not meet all the requirements for registration) n Final certificate of registry (ship is registered) n Extract bareboat charter

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Details of bareboat charter > Do not complete questions 5.1 to 5.7 inclusive when the applicant is also the bareboat charterer (however, questions 5.8 and 5.9

must be completed in all cases)

5.1 (Company) name

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5.2 Chamber of Commerce number

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5.3 Address

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5.4 Postcode and place

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5.5 Name of contact person and deputy contact person

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5.6 Telephone number(s)

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5.7 E-mail address

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5.8 Date signature

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5.9 Charter period

| From: (dd-mm-yyyy) | To: (dd-mm-yyyy)

6

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Details of owner

6.1 Name

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6.2 Address

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6.3 Postcode and place

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7



Details of ship

7.1 Name ship

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7.2 Call sign and registration mark

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7.3 IMO number and home port

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7.4 Type of ship

n Merchant shipping n Bulk carrier n Oil/Chemical tanker n Chemical tanker n Commercial cruise ship

n Container ship n Gas carrier

n Reefer ship n Oil tanker n Passenger ship n Product tanker n RORO passenger ship n RORO cargo ship n Sports fishing vessel n Livestock ship n Cargo ship n Sailing passenger ship

n Sailing training ship n Heavy cargo ship

n Submarine n Offshore n Supply vessel n Mobile drilling unit n Offshore support vessel n Oil recovery vessel n Survey/patrol vessel n Personnel transfer vessel n Tug

ILT.109E.02 | 2 of 4

Application

Bareboat registration and certificate of merchant shipping Human Environment and Transport Inspectorate Ministery of Infrastructure and the Environment

n Dredgers and contractor equipment n Suction dredger n Backhoe/dipper dredger n Trailing suction hopper dredger n Cutter suction dredger

n Split hopper barge n Split hopper dredger

n Stone dumping vessel

n Dredger (other) n Salvage vessel

n Floating dock n Floating crane n Pontoon n Workboat 7.5 Is the ship equipped with or without propulsion?

n With propulsion (standard)

7.6 Hull material

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7.7 Date of buildi and building number

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7.8 Built in (place and country)

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7.9 Built by (shipyard name)

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7.10 Gross tonnage and net tonnage

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n Without propulsion n Without propulsion, manned operation

Ship arrangement

7.11 Number of decks

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7.12 Number of masts

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7.13 Number of cargo spaces

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7.14 Number of funnels

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7.15 Number of hatchways

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7.16 Number of cranes

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7.17 Location of the deckhouse/ bridge

n Fore n Middle n Aft

7.18 The ship has a

n Forecastle

8

n Poop deck

8.1 Always include

Appendices of the bareboat charterer



If the bareboat charterer is a legal entity

- A copy of the applicable articles of association of the bareboat charterer and a statement from a civil-law notary that lists the names and addresses of the directors



If the bareboat charterer is a firm or shipping company that does not have a legal entity

- A copy of the act of forming a firm or a shipping company and a statement from a civil-law notary regarding the names and addresses of the partners personnaly liable or members of the shipping company



If the bareboat charterer is a natural person

- A copy of the passport or a statement from a civil-law notary that lists the name, address, and nationality of the bareboat charterer

- Recent extract Chamber of Commerce

ILT.109E.02 | 3 of 4

Application

Bareboat registration and certificate of merchant shipping Human Environment and Transport Inspectorate Ministery of Infrastructure and the Environment

9

Appendices concerning the ship

9.1 Enclose the following appendices concerning the ship

- A recent officially certified copy of the registration of the seagoing vessel outside the Netherlands (including the name of the ship, registration number, name en address of the property register) - A declaration that the laws of the state where the ship is registered do not constitute an obstacle to flying the Dutch flag - A copy of the (provisional) international tonnage certificate - An officially certified document specifying the engine data; it must at least specify the rotary speed, power, and the engine number

10

Signature applicant I declare that all details on this form have been completed fully and truthfully.

10.1 Place and date

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10.2 Signature of applicant

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11

Signature of owner The owner and bareboat carrier (if the latter is not the owner) agree to the assignment of the concerned seagoing ship as a Dutch ship

11.1 Place and date

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11.2 Signature of owner/ bareboat carrier (if applicable)

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12

Signature of bareboat charterer The bareboat charterer herewith declares to accept the responsibility for the ship and those on board as arising from the ship being a Dutch ship.

12.1 Place and date

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12.2 Signature of bareboat charterer

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ILT.109E.02 | 4 of 4