Form FMC-65 Foreign-Based Unlicensed NVOCC Registration/Renewal

46 CFR 515- Licensing, Financial Responsibility Requirements, and General Duties for Ocean Transportation Intermediaries and Related Forms.

FMC Form 65 - Foreign Bassed Unlicensed NVOCC Registration Renewal Form

Foreign-Based Unlicensed NVOCCs

OMB: 3072-0018

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Form FMC-65 Foreign-based Unlicensed NVOCC Registration/Renewal


Page 1

Form FMC-65 OMB No. 3072-____ (Expires _______)


FOREIGN-BASED UNLICENSED NVOCC REGISTRATION/RENEWAL


1. Legal Name of Registrant:


_______________________________________________________________________________

Name listed above must match legal name on official documentation exactly, including punctuation


2. Trade Name(s): _________________________________________________________________


3. Principal Place of Business Address - number, street, and room or suite number:


_________________________________________________________________________________

City or town, and Country (include applicable postal codes)


4. Telephone Number (include country code): Fax Number (include country code):


_______________________________________________________________________________


5. Name of Contact Person: Email Address of Contact Person:


_______________________________________________________________________________


6. Legal Agent for Service of Process in the U.S.:


Name of Agent:

_______________________________________________________________________________



Address - number, street, and room or suite number:


______________________________________________________________________________


City or town, state, and zip code:


________________________________________________________________________________


Telephone Number: Fax Number:


_________________________________________________________________________________


Name of Contact Person: Email Address of Contact Person:


______________________________________________________________________________

Page 2


Form FMC-65 OMB No. 3072-____ (Expires _______)


CERTIFICATION


I certify that I have read a copy of the Federal Maritime Commission’s ocean transportation intermediary regulations, 46 CFR Part 515, and pertinent sections of the Shipping Act of 1984, as amended by the Ocean Shipping Reform Act of 1998 and the Coast Guard Authorization Act of 1998 (46 U.S.C. 40101 et seq.), governing ocean transportation intermediaries, and that I will abide by all the provisions thereof from this date forward.


I further certify that I shall use a licensed ocean transportation intermediary for any ocean transportation intermediary activities performed on my behalf in the United States.


Under penalties of perjury, I declare that I have examined this registration and to the best of my knowledge and belief, it is true, correct and complete.


Note: Certification must be executed by the sole proprietor if registrant is a sole proprietorship, by all partners if registrant is a partnership, by a corporate officer if registrant is a corporation, or by a member if registrant is a limited liability company.




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Signature


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Name


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Title


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Date

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Authordslee
File Modified0000-00-00
File Created2021-01-13

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