Renewal Certification

U.S. DEPARTMENT OF
HOMELAND SECURITY
U.S. COAST GUARD
(SUBSTITUTE) CG-1280 (REV. 06/04)

OMB APPROVED 1625-0027
EXPIRATION DATE:

RENEWING ENDORSEMENTS ON A CERTIFICATE OF DOCUMENTATION
Vessel owners are required to renew the endorsement(s) on Certificates of
Documentation each year. Failure to renew the endorsement(s) may result in the vessel
being removed from documentation. Operation of a vessel with expired endorsements
may result in a civil penalty.
If the vessel has been lost, sold, abandoned, destroyed, or placed under state numbering,
the vessel owner must notify the National Vessel Documentation Center in writing. If the
Certificate of Documentation is available, it must be surrendered. If any of the
information shown on the Certificate of Documentation, other than the address of the
owner, has changed, please contact the National Vessel Documentation Center for advice
on how to proceed. The toll free telephone number is 1 800 799-8362.
The endorsement(s) may be renewed by completing the substitute form CG-1280 which
is published below. The Certification may be sent by facsimile mail to the National
Vessel Documentation Center at (304) 271-2405. Although facsimile submissions are
preferred, the Certification may be mailed to the National Vessel Documentation Center,
792 T J Jackson Drive, Falling Waters, WV 25419.

RENEWAL CERTIFICATION
I CERTIFY THAT THE RECITATIONS CONCERNING VESSEL NAME, TONNAGE,
DIMENSIONS, PROPULSION, OWNERSHIP, RESTRICTIONS, ENTITLEMENTS AND
EMPLOYMENT CONTAINED IN THE CERTIFICATE OF DOCUMENTATION ISSUED TO THE
VESSELS NAMED BELOW HAS NOT BEEN LOST, MUTILATED, OR WRONGFULLY
WITHHELD.
NAME(S) AND OFFICIAL NUMBER(S) OF VESSELS COVERED BY THIS CERTIFICATION: (May
be listed on an attachment if necessary)

OWNER’S ADDRESS (IF CHANGED FROM ADDRESS SHOWN ON CERTIFICATE OF
DOCUMENTATION)

Authorized Signature

Capacity of Person Signing

Date

AN AGENCY MAY NOT CONDUCT OR SPONSOR, AND A PERSON IS NOT REQUIRED TO RESPOND TO A COLLECTION OF INFORMATION
UNLESS IT DISPLAYS A VALID OMB CONTROL NUMBER.
THE COAST GUARD ESTIMATES THAT THE AVERAGE BURDEN FOR THIS FORM IS 5 MINUTES. YOU MAY SUBMIT ANY COMMENTS
CONCERNING THE ACCURACY OF THIS BURDEN ESTIMATE OR MAKE SUGGESTIONS FOR REDUCING THE BURDEN TO: U.S. COAST
GUARD, NATIONAL VESSEL DOCUMENTATION CENTER, 792 T J JACKSON DRIVE, FALLING WATERS, WEST VIRGINIA 25419, OR OFFICE
OF MANAGEMENT AND BUDGET, PAPERWORK REDUCTION PROJECT (1625-0027), WASHINGTON, DC 20503.