CG-1280 (05/20) Vessel Renewal Notification Application for Renewal

DEPARTMENT OF HOMELAND SECURITY

U.S. Coast Guard
VESSEL RENEWAL NOTIFICATION
APPLICATION FOR RENEWAL
RETURN TO:

OMB No: 1625-0027
Expires: 04/30/2023

NATIONAL VESSEL DOCUMENTATION CENTER
PO BOX 1119
FALLING WATERS, WV 25419-1119

NOTICE: RECREATIONAL VESSEL OWNERS WHO WISH TO RENEW FOR MORE THAN ONE YEAR MAY DO SO BY INCLUDING ADDITIONAL FEES
IN THE AMOUNT OF $26.00 PER EXTRA YEAR REQUESTED, AND ANNOTATING SAME ON THE CG-7042 CREDIT CARD FORM, OR IN THE MEMO
LINE OF CHECKS.
RENEWAL REQUESTS RECEIVED UP TO 30 DAYS AFTER THE EXPIRATION DATE OF THE COD WILL BE CONSIDERED 'LATE' AND WILL
REQUIRE PAYMENT OF AN ADDITIONAL $5 LATE FEE.
RENEWAL REQUESTS RECEIVED 31 DAYS AFTER THE EXPIRATION DATE OF THE COD WILL RESULT IN THE COD BEING 'EXPIRED' AND WILL
REQUIRE REINSTATEMENT, WITH A PAYMENT OF $84.00. FOR MORE INFORMATION ON REINSTATEMENT, VISIT OUR WEBSITE AT
www.uscg.mil/nvdc FOR INSTRUCTIONS AND FORMS REPLACEMENT AND REINSTATEMENT DOCUMENTATION.
PAYMENT OPTIONS:
RECREATIONAL VESSELS: Single Vessel with 1 year renewal - pay ONLINE at www.uscg.mil/nvdc
Single Vessel with MORE THAN 1 YEAR (2 TO 5 YEARS)-See Pay by CREDIT CARD, CHECK OR MONEY ORDER below.
COMMERCIAL VESSELS: Single Vessel with 1 year renewal (COMMERCIAL LIMITED TO ONE YEAR ONLY) - Pay ONLINE at www.uscg.mil/nvdc
PAY BY CREDIT CARD, CHECK OR MONEY ORDER: IF PAYING BY CREDIT CARD, SUBMIT COMPLETED CG-1280 AND CG-7042 AUTHORIZATION
FOR CREDIT CARD TRANSACTIONS. IF PAYING BY CHECK OR MONEY ORDER, SUBMIT COMPLETED CG-1280 AND CHECK OR MONEY ORDER
PAYABLE TO : U.S. COAST GUARD
COMPLETING THE CG-1280:
1. If the CG-1280 was mailed to you, sign, date and indicate Capacity of Person signing. Enter change of address information, if applicable.
2. If you obtained a blank, fillable form from our website, insert name and address in upper left corner of form to the left of the NVDC return address. Enter
change of address information below, if applicable. Sign, date, indicate Capacity of Person signing AND enter Vessel Name and Official Number in block
titled VESSEL NAME AND OFFICIAL #.
3. Recreational vessel owners ONLY may choose to renew for a period of 1-5 years as per the above NOTICE.
NOTE: Contact the National Vessel Documentation Center at (800) 799-8362 or (304) 271-2400 Eastern Standard Time to make any change other than address.

Mail completed form and payment to the address listed above, or e-mail to [email protected].

AN AGENCY MAY NOT CONDUCT OR SPONSOR AND A PERSON IS NOT REQUIRED TO RESPOND TO A COLLECTION OF INFORMATION UNLESS IT DISPLAYS A VALID OMB CONTROL NUMBER.
THE COAST GUARD ESTIMATES THAT THE AVERAGE BURDEN FOR THIS FORM IS 5 MINUTES. YOU MAY SUBMIT ANY COMMENTS CONCERNING THE ACCURACY OF THIS BURDEN ESTIMATE
OR ANY SUGGESTIONS FOR REDUCING THE BURDEN TO: U.S. COAST GUARD, NATIONAL VESSEL DOCUMENTATION CENTER, 792 T J JACKSON DRIVE, FALLING WATERS, WEST VIRGINIA
25419 OR OFFICE OF MANAGEMENT AND BUDGET, PAPERWORK REDUCTION PROJECT (1625-0027), WASHINGTON, DC 20593.

PLEASE INDICATE ADDRESS CHANGE BELOW. (A PHYSICAL ADDRESS IS REQUIRED WHEN USING A POST OFFICE BOX.)
PRIVACY ACT STATEMENT
1. AUTHORITY: 5 U.S.C. 301, DEPARTMENTAL REGULATIONS; 46 U.S.C. CHAPTER 121, DOCUMENTATION OF VESSELS.
2. PURPOSE: INFORMATION IS REQUIRED TO RENEW VESSEL CERTIFICATES OF DOCUMENTATION (COD).
3. ROUTINE USES: AUTHORIZED USCG PERSONNEL WILL USE THIS DATA TO VERIFY VESSEL’S OWNER/AGENT INFORMATION AND TO ACCOUNT FOR RENEWAL FEES. ANY DISCLOSURES
OF DATA WITHIN THIS RECORD WILL BE MADE IN ACCORDANCE WITH DHS/USCG-013, MARINE INFORMATION FOR SAFETY AND LAW ENFORCEMENT (MISLE), 74 FEDERAL REGISTER (FR)
30305, JUNE 25, 2009, AND DHS/ALL-007 ACCOUNTS PAYABLE SYSTEM OF RECORDS, 80 FEDERAL REGISTER (FR) 58286, SEPTEMBER 28, 2015.
4. CONSEQUENCES OF FAILURE TO PROVIDE INFORMATION: VOLUNTARY. HOWEVER, FAILURE TO PROVIDE THE REQUESTED INFORMATION MAY RESULT IN THE EXPIRATION OF YOUR
COD AND LATE FEES BEING ASSESSED.

NAME

E-MAIL ADDRESS

PHYSICAL ADDRESS

P.O. BOX

CITY, STATE, ZIP

CITY, STATE, ZIP

POTENTIAL PENALTIES FOR FALSE STATEMENTS OR REPRESENTATION BY OWNER OR REPRESENTATIVE: VESSEL FORFEITURE (46 USC 12151) & FINE AND/OR IMPRISONMENT (18 USC 1001).

I CERTIFY THAT THE RECITATIONS CONCERNING THE VESSEL: NAME, TONNAGE, DIMENSIONS, PROPULSION, OWNERSHIP, HAILING PORT, RESTRICTIONS,
ENTITLEMENTS, REMARKS AND ENDORSEMENTS CONTAINED IN THE CERTIFICATE OF DOCUMENTATION REMAIN ABSOLUTELY THE SAME. CONTACT THE
NATIONAL VESSEL DOCUMENTATION CENTER FOR ANYTHING OTHER THAN CHANGE OF ADDRESS.

VESSEL NAME AND OFFICIAL #
AUTHORIZED SIGNATURE
CAPACITY OF PERSON SIGNING (OWNER/AGENT)

CG-1280 (05/20)

DATE

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