MA-1025 Vessel Data and Capital Costs

OMB No. 2133-0514
Expires 06/30/2011

Instructions for Form MA-1025, Vessel Data and Capital Costs
A federal agency may not conduct or sponsor, and a person is not required to respond to, nor shall a person be subject to a penalty for failure
to comply with a collection of information subject to the requirements of the Paperwork Reduction Act unless that collection of information
displays a current valid OMB Control Number. The OMB Control Number for this information collection is 2133-0514. Public reporting for
this collection of information is estimated to be approximately 1 hour per response, including the time for reviewing instructions, completing
and reviewing the collection of information. All responses to this collection of information are voluntary. Send comments regarding this
burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to: Information Collection
Clearance Officer, Maritime Administration, MAR-390, 1200 New Jersey Avenue, SE, Washington, DC 20590.

This information is required by 46 CFR Part 382.2. The information requested must be completed with the company's initial filing to Maritime Administration.
After the initial filing, this information need only be resubmitted when changes occur. Speed and fuel consumption and capitalization should be reevaluated
on an annual basis but need not be reported unless changes occur. Use additional sheets as necessary.

Vessel Name:

Current Official Name.

Vessel DWT:

Summer deadweight tons per classification society.

Vessel Official Number:

U.S. Coast Guard Official No.

Date Built:

Date of delivery.

Date Purchased:

Date vessel was purchased if different from date of delivery.

Date Rebuilt:

Date of redelivery if vessel was substantially reconstructed.

Canal Tonnages:

Suez and Panama as applicable

Normal Operating Speed:

Normal operating speeds, loaded and ballast.

Daily Fuel Consumption:

Fuel consumed by specific type of fuel per day at sea and in port.
Tankers should provide standing and pumping separately.
Provide fuel consumption in metric tons or gallons.

Capitalized Vessel Costs:

For each capitalized item, provide the amount of capitalization
and the interest rate associated with the capitalization, if secured
by mortgage. If the interest rate is variable, provide the formula.
If the interest rate is subject to change or renegotiation, provide
the new interest rate prior to implementation of the change.

Certification Statement:

All information submitted to MARAD must be certified by a
responsible officer of the company. A cover letter listing all
enclosures by vessel and certifying their accuracy can be used
as an alternative to vessel by vessel certifications.

OMB No. 2133-0514
Expires 06/30/2011
U.S. Department of Transportation
Maritime Administration

VESSEL DATA AND CAPITAL COSTS
Vessel Name:
Vessel DWT:

Date Built:

Official No.:

Date Purchased: (if applicable)

Date Rebuilt: (if applicable)

Canal Tonnage:

Suez Canal
Net

Gross

Vessel Dimensions:

Length

Panama Canal
Net

Gross

Breadth

Normal Operating Speed:

Loaded

In Ballast

Daily Fuel Consumption:
Fuel Type

At Sea*
MT or GAL

In Port
Standing

Pumping**

Capitalized Vessel Costs
Capital Item

Amount

Date of Capitalization

Rate of Interest On
Associated Debt***

I hereby certify that I have carefully examined the foregoing form and to the best of my knowledge and
belief the information contained herein is true, accurate and complete.
Signature

Title

Date

* At normal operating speed
**If applicable
***List only debt secured by a mortgage on the vessel. If serial bonds, list the original principle amount and
interest rate for each series. If the interest rate is variable, list formula, I.e., LIBOR +1%.
FORM MA-1025 (4/01)