Application For Vessel Registration
Application For Vessel Registration
Application For Vessel Registration
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<strong>Vessel</strong> <strong>Registration</strong> <strong>For</strong>m<br />
Service Required (Please tick ( √)<br />
appropriate box)<br />
¨ <strong>Vessel</strong> <strong>Registration</strong> ¨ Renew <strong>Vessel</strong> <strong>Registration</strong> ¨ Modify Information of VRC ¨ Issue VRC Los/Damaged<br />
¨ Cancelation & Property Certificate ¨<strong>Vessel</strong> Re-<strong>Registration</strong> ¨ Changing of <strong>Vessel</strong> Number ¨ <strong>Vessel</strong> Information Inquiry<br />
<strong>Vessel</strong> File No. …………………… Owner File No. ………………….. Traffic File No. ………………….<br />
<strong>Registration</strong> Type ¨ Commercial <strong>Registration</strong> ¨ Recreation <strong>Registration</strong><br />
Details of Owner<br />
(where more than one person owned the vessel, the vessel registered in the name of the owner designated by the court and all other owners<br />
information should be provided in attached additional forms )<br />
<strong>For</strong> Commercial registration only<br />
Name:……………………………………………………………………………………………………….<br />
Sex: Male ¨ Female ¨ Company Name:……………………….<br />
Nationality:……………………………… Ownership Sharing (%):………………… Trade License No.:……………………<br />
…….<br />
Date of Birth:…….….../…..…../……………. Passport or ID Number:…………………. Issuance Authority:……………………<br />
Date of Issue:……./….…/………………Date of Expiry:……/…./…………………<br />
Tel. :……………………………………... Fax:……...………………………………..<br />
Date of Issuance:……..……………….<br />
Date of Expiry:………………………..<br />
Mobile:…………………………………………….. P.O. Box……….………………………… Tel:……………………………………….<br />
Emirate :… ……………………………....E-mail:…………………………………..<br />
.<br />
Fax:……………………………………..<br />
Address:………………………………………………………………………………….<br />
Location:………………………………………..<br />
Details of <strong>Vessel</strong><br />
Hull Identification Number (HIN):…………………………….. <strong>Registration</strong> Number:<br />
<strong>Vessel</strong> Name:……...............................................................<br />
Previous <strong>Registration</strong> Port (if applicable):……………………<br />
…………………………………………………………………<br />
Previous <strong>Vessel</strong> Name (if applicable):………………………….<br />
…………………………………………………………………<br />
<strong>Vessel</strong> Manufacturer:…………………………………………<br />
Place of Build:……………… Year of Build:………………….. Net Tonnage:………………... Gross Tonnage:………………..<br />
Length (m/ft):……. Beam(m/ft):………. Depth (m/ft):… …... Draft(m/ft):………...<br />
No. of Crew:…… No. of Passengers:…… Mortgage Party:……………… Mortgage Reference……<br />
<strong>Vessel</strong> Type<br />
¨ RB Recreation Boat ¨ TB Tourist Boat ¨ FB Ferry Boat ¨ CR Cruise<br />
¨ FR Floating Restaurant ¨ WB Water Bus ¨ WT Water Taxi ¨ AB Abra<br />
¨SB Service Boat ¨ JS Jet Ski ¨ Other (please specify):……………………………………………………<br />
<strong>Vessel</strong> Use<br />
¨ Commercial ¨ Tourist ¨ Pleasure ¨ Transport<br />
¨ Skiing<br />
¨ Other (please specify)<br />
Technical Inspection Locations<br />
¨ ¨ ¨ ¨<br />
Other (please specify for inspection purpose):…………………………………………………………………………………………………<br />
QFO-3.3. 1.VM_1 Issue: 1.0<br />
Page 1 of 2
Construction Material<br />
¨ Steel ¨ Aluminum ¨ Plywood ¨ Fiberglass ¨ Timber<br />
¨ Polyethylene ¨ Rubber ¨ Other (please specify):…………………………………………………………<br />
Hull Color<br />
¨ White ¨ Black ¨ Blue ¨ Red ¨ Yellow<br />
¨ Green ¨ Brown ¨ Cream ¨ Silver ¨ Unpainted<br />
¨ Other (please specify):…………………………………………………………………………………………………………………………….<br />
Topside Color<br />
¨ White ¨ Black ¨ Blue ¨ Red ¨ Yellow<br />
¨ Green ¨ Brown ¨ Cream ¨ Silver ¨ Unpainted<br />
¨ Other (please specify):…………………………………………………………………………………………………………………………..<br />
<strong>Vessel</strong> Propulsion and Engine Details<br />
<strong>Vessel</strong> Propulsion ¨ Engine driven ¨ Sails ¨ Oars ¨ Other (please specify)<br />
Engine Location ¨ Inboard ¨ Outboard ¨ Other(please specify)<br />
Engine Particular- 1 st Engine<br />
Fuel ¨ Petrol ¨ Diesel ¨ Gas ¨ Other(please specify)<br />
Engine Type ¨ Two Stroke ¨ Four Stroke ¨ Rotary ¨ Other(please specify)<br />
Manufacturer's Name:……………………………… Serial No.:…………………..………………………<br />
Horse Power:………………………….. Kilowatt:……………………… ………. Engine Size (CC):……………………..<br />
Engine Particular- 2nd Engine<br />
Fuel ¨ Petrol ¨ Diesel ¨ Gas ¨ Other(please specify)<br />
Engine Type ¨ Two Stroke ¨ Four Stroke ¨ Rotary ¨ Other(please specify)<br />
Manufacturer's Name:……………………………………… Serial No.:……………………..……………………<br />
Horse Power:………………………….. Kilowatt:……………………… ………. Engine Size (CC):……………………..<br />
Preserve Current <strong>Registration</strong> Number:<br />
Would you like to preserve the current <strong>Registration</strong> Number? ¨ Yes ¨ No<br />
(if answer yes please fill the form for preserving the registration number)<br />
Applicant Name and Signature<br />
Name:…………………………………………………………………………………………………………………………………….<br />
Signature:…………………………………………………………..........Date…………/………./………..………………………..<br />
Official Use Only:<br />
Official Employee Name:………………………………………………………………………………………………………..<br />
Signature:……………………………………………………………….. Date…………/………./………..………………………….<br />
Note: <strong>Registration</strong> process should be completed within 30 days, otherwise registration will be cancelled after that.<br />
QFO-3.3. 1.VM_1 Issue: 1.0<br />
Page 2 of 2
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