Form 83 Service Contract Registration

OMB Control No. 3072-0065
(expires XX-XXXX)

ORGANIZATION NO.

PLEASE TYPE OR PRINT

SERVICE CONTRACT REGISTRATION
(SEE ATTACHED INSTRUCTIONS)

1. Organization Number
2. Registrant Type
(Check all that applies)

[ ] VOCC

[ ] Tariff Publisher/Agent/Other

[ ] Agreement

[ ] Conference/Joint Service

3. Registrant
Full Legal Name of firm (or individual, if not a firm)
(Doing Business As)

4. This Registration is:

[ ] Initial

[ ] Amendment (Specify change)

[ ] Dial-up

[ ] Internet-based

5. Address of
Home Office

(
(Number and Street)

)

Telephone

(Please record any changes)

(
(Number and Street)

(City/State/Country)

6. Billing
Address If
Different

(Federal TIN Number)

)
Fax

E-Mail (optional)

(

)

(Number and Street)

Telephone

(Number and Street)

Fax

(City/State/Country)

E-Mail (optional)

(

)

7. Permissions Requested and Person granted these permissions : For the Internet-based system, please list individual(s) who will
need logons. If the individual is a publisher, a letter of authority must be submitted.

Full Legal Name

If this is transfer of logon, please list for each the
Existing Log-on____________________

File Service Contracts


Signature of Authorized Official

Print or Type name of Authorized Official

date

FMC USE ONLY
Logon__________________Initial Password__________________ID___________________Directory__________________
DateAsg_____/_____/_____AsgBy___________________________
Form FMC-83 (3/17)

INSTRUCTIONS FOR FORM FMC-83

INSTRUCTIONS
Line 1. Organization Number: Complete if known. (Regulated Persons Index or
“RPI” number.)
Line 2. Registrant Type: Indicate the type of organization. Please check all that
applies.
Line 3. Registrant: This must be the full name of the firm or individual registering
for the FMC’s Service Contract Filing System and any trade names. The registrant
name should match the corporate charter or business license, conference
membership, etc. It should be noted that the registrant name cannot be changed by
the registrant after the registration without submission of an amended registration
form.
Line 4. Registration: Indicate whether this is the initial (first time) registration or an
amendment to an existing Service Contract Registration.
Line 5. Address of Home office: The complete street address should be shown in
addition to the post office box. Also, provide the registrant’s Federal Taxpayer
Identification Number (“TIN” Number).
Line 6. Billing Address if Different: This should be completed if the billing address
differs from the home office address. Show the firm name (if different from the
registrant), street address and post office box (if applicable).
Line 7. Permissions Requested and Person Granted These Permissions: Delegation
of the authority to file should be noted here. The person listed in line 7 is authorized
only to submit filings.

PAPERWORK REDUCTION ACT NOTICE
The collection of this information is authorized generally by 46 U.S.C. § 40502(b).
This is an optional form. Submission is completely voluntary. However, failure to submit this form will prevent you from electronically filing service
contracts with the FMC in accordance with 46 U.S.C. § 40502(b)(1).
You are not required to provide the information requested on a form that is subject to the Paperwork Reduction Act unless the form displays a valid
OMB control number. The valid control number for this information collection is 3072-0070 Copies of this form will be maintained until the filer
indicates s/he will no longer file NSAs into the electronic filing system.
The time needed to complete and file this form will vary depending on individual circumstances. The total estimated average time to complete this
form is 6 minutes.
If you have comments concerning the accuracy of this time estimate or suggestions for making this form simpler, we would be happy to hear from
you. You can write to the Secretary, Federal Maritime Commission, 800 North Capitol Street, N.W., Washington, D.C. 20573-0001, or e-mail:
[email protected].
PRIVACY ACT STATEMENT
FORM FMC-83 - SERVICE CONTRACT REGISTRATION
Pursuant to 5 U.S.C. § 552a(e)(3), enacted into law by Section 3 of the Privacy Act of 1974 (Public Law 93-579), the following statement is furnished
to individuals who supply information to the Federal Maritime Commission (FMC) on Form FMC-83. This information is maintained in a system of
records designated as FMC-40 and described at 78 FR 55699 (September 11, 2013), and on the FMC website at
http://www.fmc.gov/assets/1/Page/SORN2013.pdf. 1.
AUTHORITY: 46 U.S.C. § 40502(b)
2.
PRINCIPAL PURPOSE(S): Pursuant to 46 U.S.C. § 40502(b)(1), a service contract entered into between an ocean common carrier or an
agreement of ocean common carriers and a shipper shall be filed with the FMC. The FMC’s regulations at 46 C. F.R. part 530 provide for electronic
filing of service contracts into the Service Contract Filing System (SERVCON). This form collects registration information from an applicant requesting
to file service contracts in SERVCON in order to issue a Log-on ID and a Password needed to access the SERVCON system.
3.

ROUTINE USE(S): The SERVCON records are used or may be used:
a.
b.
c.
d.
e.
f.
g.

By Authorized Organization Representatives for official filing of VOCC related contracts to FMC.
By Authorized Organization Representatives to make approved changes and amendments to filed contracts.
By Authorized Organization Representatives to upload Notices with various information relevant to filed contracts that may be
viewed by Commission Officials.
By Commission Officials and Authorized Local Users from other Federal Agencies to verify and review the validity of the contract
and operations of registered VOCCs and NVOCCs.
To refer, where there is an indication of a violation or potential violation of law, whether civil or criminal or regulatory in nature,
information to the appropriate agency, whether Federal, State, or local, charged with the responsibility of investigating or
prosecuting such violation or charged with enforcing or implementing the statute, rule, regulation or order issued pursuant thereto.
By a court of law or appropriate administrative board or hearing having review or oversight authority.
To appropriate agencies, entities, and persons when (a) the Federal Maritime Commission suspects or has confirmed that the
security or confidentiality of information in the system of records has been compromised; (b) the agency has determined that as a
result of the suspected or confirmed compromise there is a risk of harm to economic or property interests, identity theft or fraud, or
harm to the security or integrity of this system or other systems or programs (whether maintained by the agency or another
agency or entity) that rely upon the compromised information; and (c) the disclosure made to such agencies, entities, and persons
is reasonably necessary to assist in connection with the agency’s efforts to respond to the suspected or confirmed compromise
and prevent, minimize, or remedy such harm.

4.
WHETHER DISCLOSURE IS MANDATORY OR VOLUNTARY AND EFFECT ON INDIVIDUAL IF NOT PROVIDING INFORMATION: This
is an optional form. Submission is completely voluntary
5.
SYSTEM MANAGER(S) AND ADDRESS: Federal Maritime Commission, Bureau of Trade Analysis, 800 North Capitol Street, N.W.,
Washington, DC 20573-0001.