Initial Vessel Documentation

INITIAL FORM

"*" indicates required fields

Step 1 of 4

NOTE: FILING THIS APPLICATION DOES NOT ENTITLE A VESSEL TO DOCUMENTATION OR TO ANY CHANGES SOUGHT ON A CERTIFICATE OF DOCUMENTATION. OFFICIAL NUMBERS DESIGNATED ON THE BASIS OF THIS APPLICATION ARE NOT TRANSFERABLE. ONLY A CURRENT CERTIFICATE OF DOCUMENTATION IS VALID FOR VESSEL OPERATION. IN ORDER FOR A VESSEL TO BE DOCUMENTED UNDER U.S. COAST GUARD DOCUMENTATION, THE VESSEL MUST MEASURE AT LEAST FIVE NET TONS (WITH THE EXCEPTION OF CERTAIN OIL SPILL RESPONSE VESSELS) AND BE WHOLLY OWNED BY A CITIZEN OF THE UNITED STATES. VESSELS OF MORE THAN 25 FEET ARE LIKELY TO MEASURE FIVE NET TONS.

A.Vessel Name (Required)*

Insert name by which you wish the vessel to be known. If applying to change the vessel's name, insert the old vessel name in parenthesis. Only standard Alpha and Numeric Characters in the vessel name will appear on the Certificate of Documentation. Click icon for attachment if application covers multiple vessels.

Please select from the following:

I already own this vessel

I purchased this vessel from another owner

This vessel was just built

B. OFFICIAL # (IF AWARDED)

Insert the Official Number (O/N) awarded by the Coast Guard for all but Initial Issue cases.

C. HULL ID # (IF ANY)

Insert Hull Identification Number (HIN) as assigned in accordance with 33 CFR 81.

D. IMO # (IF ANY)

Insert International Maritime Organization Number (IMO), if any.

E. HAILING PORT INCLUDING STATE (TO BE MARKED ON VESSEL)

Insert name of place and state exactly as it is or will be marked on the vessel. The hailing port must be a place in the United States. Commonly used abbreviations such as ‘NY, NY’ are acceptable.

F. NAME OF MANAGING OWNER, E-MAIL ADDRESS, TELEPHONE NUMBER:

Name, e-mail address, and telephone number of the owner to whom the Coast Guard should send correspondence and their Social Security Number (SSN) or Tax Identification Number (TIN). Only an owner or part owner can be the managing owner. For vessels owned by a corporation, the corporation is the managing owner. For a trust arrangement, the trustee is the managing owner. For a Partnership or a LLC, the name of the Partnership or the LLC should be shown.

NAME OF MANAGING OWNER

E-MAIL ADDRESS OF MANAGING OWNER

TELEPHONE NUMBER OF MANAGING OWNER

SOCIAL SECURITY OR TAX ID NUMBER (46 USC 12104): (SECURE FORM)

IS THIS NUMBER YOUR SOCIAL SECURITY NUMBER OR YOUR TAX ID NUMBER?

SOCIAL SECURITY NUMBER

TAX ID NUMBER

G. PHYSICAL ADDRESS OF MANAGING OWNER (REQUIRED – 46 CFR 67.113)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

MAILING ADDRESS OF MANAGING OWNER (IF DIFFERENT THAN PHYSICAL ADDRESS – E.G. , P.O. BOX)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

H. Are There Other Persons / Entities That Own an Interest in the Vessel?

If no, leave as is, otherwise select yes. Include all persons/entities (other than managing owner) who own an interest in the vessel below.

Additional Vessel Interest Owners

Name / Entity	Actions

There are no Entries.

I. PURPOSE OF APPLICATION*

Check applicable blocks to show purpose of application. If vessel has never been documented, check Block #5 and provide ALL requested information known about the vessel's place and year of build, hull material, approximate length, and previous names and numbers. If this information is unknown, please indicate.

1. TRANSFER/EXCHANGE OF CERTIFICATE OF DOCUMENTATION

2. REPLACEMENT OF LOST, WRONGFULLY WITHHELD OR MUTILATED CERTIFICATE OF DOCUMENTATION

3. RE-INSTATEMENT OF CERTIFICATE OF DOCUMENTATION FOLLOWING FAILURE TO RENEW

4. RETURN TO DOCUMENTATION FOLLOWING DELETION.

5. APPLICATION FOR OFFICIAL NUMBER AND FIRST CERTIFICATE OF DOCUMENTATION.

VESSEL NAME WHEN LAST DOCUMENTED:

VESSEL

WAS BUILT AT

IS UNDER CONSTRUCTION AT

City, State, Country

Month, Year

IS UNDER CONSTRUCTION AT

AND IS SCHEDULED FOR COMPLETION IN

HULL MATERIAL:

WOOD

STEEL

FIBROUS REINFORCED PLASTIC

ALUMINUM

CONCRETE

OTHER

DESCRIBE

OVERALL VESSEL DIMENSIONS:

Overall Length (L):

Overall Breadth (B):

Overall Depth (D):

PREVIOUS NAMES, NUMBERS, OR FOREIGN REGISTRATIONS OF VESSEL

J. ENDORSEMENTS FOR WHICH APPLICATION IS MADE

Check the appropriate block(s) to indicate all endorsement(s) sought on this application.

RECREATIONAL

FISHERY

COASTWISE

REGISTRY

COASTWISE – BOWATERS ONLY (CERTIFICATE ON FILE)

COASTWISE – OIL SPILL RESPONSE ONLY (LETTER OF QUALIFICATION ON FILE)

COASTWISE UNDER CHARTER TO AN ENTITY QUALIFIED TO ENGAGE IN COASTWISE TRADE (COPY OF CHARTER ON FILE)

K. PRIMARY SERVICE & HORSEPOWER: SELECT ONLY ONE SERVICE FOR WHICH THE VESSEL WILL BE PRIMARILY USED AND INSERT HORSEPOWER

HORSEPOWER

Credit Card

Card Details

Cardholder Name

Having Trouble? Check this box to move forward without your Credit Card

*My card information is not working; I would like to continue my submission and receive a call from a specialist regarding payment

BILLING ADDRESS*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Email*

Enter Email Confirm Email

Phone*

(###) ###-####

INITIAL FORM

PRIORITY REQUEST REQUEST / RUSH PROCESSING

PREFERRED MORTGAGE

SATISFACTION OF MORTGAGE