APPLICATION FOR INTERNATIONAL TONNAGE CERTIFICATE – ITC 69
(***Incomplete applications will be declined***)
Vessel Name: ______Patente No. ______
Call Letters: ______Gross Tonnage: ______
IMO No.: ______Year Keel was laid: ______
Name/Address/Tel & Fax of vessel Operator (to be Name/Address/Tel/Fax and private courier account of the
to be Included at all times) Company responsible for receiving original documents and paying for invoices (if different from Operators):
I. This Administration only in cases on which the vessel change its name or that the Original Certificate has been lost/ need a duplicate of a previous ITC issued or endorsed by Administration, the requirement are the following:
a. Fill up the Application form
b. Panama Registry Certificate ( Patente )
c. Copy of the previous ITC 69 issued by SEGUMAR or by an accredited RO (only ITC 69 issued by a RO that shows SEGUMAR Endorsement will be accepted)
d. Confirmation of the corresponding payment/fee (100 $)
*** The ship-owner/operator ONLY applies directly to this administration for the issuance of the ITC 69 on behalf of Panama in the case of change of name or lost of the certificate according toMMC 67 (www.segumar.com)(CIRCULARS) ITEM (D) for the properly payment. (Please refer to ITEM III) below***.
II. The requirements for ITC'69 endorsements (this include for issuance of an ITC`69 for vessels newly register inclusively change of flag to Panama Flag) that hold a valid ITC 69 issued by State Signatory of the Convention, are as follows :
· Clear copy of the ITC 69 from the previous flag (only States signatory of the Convention)
· Original ITC'69 Certificate
· Copy of the Interim ITC`69
· Two (2) clear copies of the original certificate (for our records) and additional sets of copies (maximum 3) for OR records will be endorsed if requested.
· One (1) copy of the Tonnage Calculations (for our records)
· Copy of the Cargo Ship Safety Construction Certificate
· Payment of the endorsement fee as per MMC No. 67
· Copy of the General Arrangement Plan
· Panama Registry Certificate ( Patente )
NOTE:
ITC'69 Certificates do not require the Registration No., but it is requirement to have the IMO No. and the Call Sign, Name of Vessel, as well as the date in which the keel was laid or in a similar state (DATE).
In case of a major modification, the date of the modification (RE-BUILT) in the same box as the date of keel laid. Please be advised that the copies of the tonnage calculation must be reviewed, signed and stamped by the surveyor responsible for making the calculations.
In case the Administration has any doubts of the result of the calculation or there are any other discrepancies, the Administration may ask for other documents such as plans of the vessel in order to verify the calculation and a survey if it is necessary.
No. de Control: F-SEG-01-04-01 / Versión: 02 / Fecha: 14 de Septiembre de 2009 / Página 2 de 2