IMO application form

Western and Central Pacific Fisheries Convention Vessel Information Family of Forms

imoform1

Application for IMO Number

OMB: 0648-0595

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IHS Maritime

Sentinel House, 163 Brighton Road
Coulsdon, Surrey CR5 2YH
United Kingdom

REQUEST FOR IMO SHIP
IDENTIFICATION NUMBER

Tel:
Fax:
Email:

+44 (0) 3253 2100
+44 (0) 3253 2102
[email protected]

TO ENABLE UNIQUE IDENTIFICATION OF SHIPS FOR ASSIGNMENT OF AN IMO NUMBER IN ACCORDANCE WITH
IMO RESOLUTION A.600 (15), SOLAS XI I/3 and I/5, PLEASE COMPLETE THE FOLLOWING DETAILS IN CAPITALS:-

Note: Shipbuilding details are essential to issue an IMO Ship Number for Newbuildings prior to completion
CURRENT SHIP NAME / SHIPYARD ID*
FORMER NAME(S)
ORIGINAL NAME*
FLAG*
MMSI

PORT OF REGISTRY

CALL SIGN

OFFICIAL NUMBER*

TONNAGE (69 CONVENTION)

YES

GROSS*

NET*

DATE OF FLAG REGISTRATION
NO

FISHING NUMBER+
DEADWEIGHT

LENGTH OVERALL*

LENGTH B.P.

EXTREME BREADTH*

MOULDED BREADTH

MOULDED BREADTH

DRAUGHT

DATE OF KEEL LAYING

DATE OF LAUNCH

SHIPBUILDER*

DATE OF COMPLETION*

PLACE OF BUILD*

HULL No.*
HULL No.

SUB-CONTRACTOR BUILDER (if applicable)
HULL MATERIAL

SHIP TYPE DESCRIPTION
(MARPOL requirements
for OIL TANKERS)

The ship complies with regulation 13F(3) (double-hull)

yes

The ship complies with regulations 13 and 13E (SBT/PL)

yes

Other (please specify)
The ship is subject to CAS requirements of regulation 13G(7)
REGISTERED OWNER** & ADDRESS**
(Including Fax, Tel & Email)

NUMBER OF MAIN ENGINES
CURRENT CLASS SOCIETY

yes

MANAGER** & ADDRESS**
(Including Fax, Tel, Email & Website)

ENGINE TYPE

MANUFACTURER

TOTAL BHP

NUMBER OF PROPELLERS

COMPANY REQUESTING IMO NUMBER
COMPANY NAME *

CONTACT NAME *

SENDER'S EMAIL*

SENDER'S FAX NUMBER *

[ * Required Fields - all SHIPS ]

[ ** Required Fields - Ships in service only ]

Note: We cannot issue an IMO Ship No. without the above fields
[+ Distinctive Number or Letters for Fishing Vessels]

FOR OFFICE USE ONLY

LRF (10/06)

DATE RECEIVED

IMO REF. NO.

REFERRED TO

ACTIONED BY

DATE

IMO NUMBER

BY


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