Application for registration

FFA 30-Mar-09 (Page 1 of 2)

Forum Fisheries Agency Vessel Register

VID number – FFA use only

Application for Registration
1. Vessel
Name of vessel in English

(use block letters)

6. Vessel Charterer/Operator
Name
Mailing address

Flag of vessel
International radio call sign

Flag state registration number

2. Vessel's previous details

go to ' Vessel contact
details '

No

Has the vessel ever had
different details to those
given above ?

Yes

give details below

Has a previous FFA Vessel Register application been made for
this vessel ?
if a VID number was issued, provide VID
No
Yes
number below

Fax number

Phone number
E-mail address

7. Vessel Fishing Master
Name
Mailing address

VID number
Vessel's previous name

Phone number

Last radio call sign
Year change occurred

Last flag state registration number
Last country of registration

Fax number

E-mail address

8. Vessel Type
Single Purse Seiner

3. Vessel contact details
Phone number

Fax number

E-mail address

No. FADs on board

No. Auxiliary boats

Helicopter model

Group Purse Seiner
Mothership

4. Vessel owner
Name

Net boat

Search boat

Longliner
Length specified as:

Max number hooks Mainline length

Mailing address

km
Phone number

nm

Mainline material
Fax number

Polyster (black tarred or vinyl red tarred) -includes
Kuralon, Dacron and Polytex

E-mail address

Nylon or Polyamide Nylon (monofilament or braided)
Other - specify

5. Vessel Master/Captain
Name

Pole and line

Mailing address

Bunker

Troller

Fish Carrier / Reefer

Other - specify

9. Vessel Specifications
Gross tonnage
Phone number

Fax number

Year built (year of initial launch)

Country built
Hull material

E-mail address

Steel

Wood

Other – specify

Fibreglass

Aluminium

FFA 30-Mar-09 (Page 2 of 2)

Vessel length (complete all lengths )

13. Applicant declaration

Length overall

I hereby apply for 'Good Standing' of the (name of vessel)

Registered length
Lengths specified as:

Length between perpendiculars

metres

feet

Normal crew compliment

Rated speed (knots)

Amount specified as:
gallons
kilolitres

Total fuel carrying capacity
Total engine power

Amount specified as:
HP

KW

PS

Engine model
Total storage capacity

Amount specified as:

Signature
( dd

Brine (NaCl)

Air (coils)

10. Vessel's Mobile Transceiver Unit (MTU) Details

●

Visit the FFA web site or contact FFA for listing of
VMS Type-Approved MTUs and Installers.

●

Provide the MTU information details below.
●

Inmarsat Mobile Number (IMN)

●

Inmarsat Serial Number (ISN)

mm

yy )

14. Attachments
Attach the following documentation to your application:
●

Is a VMS Type-Approved MTU installed on this vessel ?

Yes

Date _____/____/____

Ice

Refrigerated sea water

No

●

cubic metres

metric tonnes
Major storage methods

On the FFA Vessel Register.
I declare that, to the best of my knowledge, there are no
outstanding matters pending in relation to this vessel or its use.
● I declare that the information provided in this application for
registration, signed by me is true, accurate and complete.
● I understand that I am required to report any changes to the
information provided within 60 days, and further understand
that failure to do so may adversely affect the good standing of
this vessel on the FFA Vessel Register.
● As the owner/charterer/duly authorised agent of the MTU
identified above, I give France Telecom permission to
download the Pacific Islands Forum Fisheries Agency's
DNID into the specified MTU.

●

a copy of the vessel's flag state registration certificate;
company ownership details and proof of corporate
registration;
a recent (12 months or less) date stamped, 15cm x 20cm
(6”x8”) color side-view & plan-view photos of the vessel;
copy of the vessel's schematic stowage plan; and
copy of the MTU inspection certificate.

15. Authorised MTU installer / Service agent details (15. &
16. required for new or replacement MTU installations)

MTU Serial Number

Name

MTU Manufacturer

Company Name

MTU Model Identification
MTU Software Version

Company contact details

11. Applicant details
Name
Mailing address

16. MTU installer declaration

Phone number

I, ___________________________________, the installer of
the Mobile Transceiver Unit identified above declare that I have
installed the specified unit in accordance with the ' Installation
and Usage Requirements for Mobile Transceiver Units ' as
published by the Pacific Islands Forum Fisheries Agency (FFA)
from time to time.

Fax number

E-mail address

The serial number of the FFA registration seal used to confirm
the MTU inspection is :

Tick the box that applies to you
Charterer

Owner

Authorised agent

FFA Registration Seal Serial Number

12. Application period
from

Year

Month

/

Month

to

Year

/

Signature _________________________ Date ____/____/____
( dd
mm yy )
(MTU installer / Service agent)

Privacy and your information

Send your completed form and documentation to:

Information provided to the Pacific Islands Forum Fisheries
Agency (FFA) on this form is confidential. Further information
about vessel registrations/ re-registrations guidelines, MTU
inspections, including instructions regarding remittance of
vessel registration fees, will be provided in a separate notice.

Forum Fisheries Agency
1 FFA Road, Kola'a Ridge
PO Box 629
Honiara
Solomon Islands

Phone: (677) 21124
Fax:: (677) 23995
email: [email protected]