Application for registration

FFA 22-Jun-15 (Page 1 of 2)

Forum Fisheries Agency Vessel Register

VID number – FFA use only

Application for Registration
(use block letters)
1. Vessel
Name of Fishing vessel in English

Flag State

International call sign

MMSI (if issued)

Flag State Number

Port of registry

6. Vessel Charterer/Commercial Operator
Name
Mailing address

Date Entered into Flag State Register
Fax number

Phone number
UVI/IMO No.
2. Vessel's previous details

Status

E-mail address

Parallel Registry (if applicable)
7. Vessel Fishing Master

Date Ship De-registered
(by the previous flag state, if applicable)

Name

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

Phone number

Vessel's previous name
Last radio call sign

Mailing address

Last flag state registration number

Last country of registration

Year change occurred

Fax number

E-mail address

8. Vessel Type
Single Purse Seiner

3. Vessel contact details
Phone number

No. FADs on board

Fax number

E-mail address

No. Auxiliary boats

Helicopter model

Group Purse Seiner
Mothership

4. Vessel Registered Owner

Net boat

Nationality

Name

Search boat

Longliner
Length specified as:

Max number hooks Mainline length

Mailing address

km

nm

Mainline material

Phone number

Fax number

E-mail address

Website

Polyster (black tarred or vinyl red tarred) -includes
Kuralon, Dacron and Polytex
Nylon or Polyamide Nylon (monofilament or braided)
Other - specify

5. Vessel Master/Captain
Pole and line

Name

Other - specify
Bunker
9. Vessel Specifications
Gross tonnage
Year built (year of initial launch)

Mailing address

Phone number

Fish Carrier / Reefer

Troller

Fax number

Ship Builder
Country built
Hull Number

E-mail address

Hull material
Steel

Fibreglass
Wood

Other – specify

Aluminium

FFA 22-Jun-15 (Page 2 of 2)

Net Tonnage

Depth
Type

Moulded Depth
Beam/
Breadth

Dead Weight

13. Applicant declaration

Beam/
Breadth Type

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

Vessel length (complete all lengths)
on the FFA Vessel Register.

Registered length

Length overall

Lengths specified as:
metres
feet

Length between perpendiculars

Normal crew compliment

Rated speed (knots)

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.

●

●

Amount specified as:
gallons
kilolitres

Total fuel carrying capacity
Total power of main Engine or Engines

Amount specified as:
●

HP

KW

PS

Engine model
Amount specified as:

Total storage capacity

cubic metres

metric tonnes
Major storage methods

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
ALC/MTU identified above and installed on this vessel, I
hereby authorise Pacific Islands Forum Fisheries Agency to
electronically monitor the unit and disseminate data received
from it, in accordance with the FFA policy.

Signature
Date _____/____/____

Ice

Refrigerated sea water

( dd

Brine (NaCl)

Air (coils)

mm

yy )

14. Attachments
10. Vessel's Mobile Transceiver Unit (MTU) Details
Visit the FFA web site (www.ffa.int) 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)

●

MTU Serial Number

Attach the following documentation to your application:
a copy of the vessel's flag state registration certificate;
a copy of valid flag state authorisation to fish outside of its
EEZ and within the WCPFC Convention Area;
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 Manufacturer
MTU Model Identification

Name

MTU Software Version

Company Name

11. Applicant details
Company contact details

Name
Mailing address

16. MTU installer declaration
Fax number

Phone number

E-mail address
Tick the box that applies to you
Charterer

Owner

Authorised agent

I, ______________________________________________,
the installer of the Mobile Transceiver Unit identified above
declare that I have installed the specified unit in accordance
with the MTU/ALC vendor's installation guidelines and the
unit has been inspected in accordance with FFA's 'MTU/ALC
Inspections Guidelines' as published from time to time.

12. Application period
from

Month

Year

Month

to

/

Year

/

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

18. UVI/IMO Required Information

17. Automatic Identification System Details

Official Number

AIS Make

Engines
Fishing
Number

Number of Engines
Previous Fishing
Number

AIS Model
AIS Serial Number

What Class AIS
is installed