SEAFARER CERTIFICATION SERVICE

CREDIT CARD PAYMENT AUTHORISATION

Family name Given names

Please tick service(s) required

EXAMINATIONS AND ASSESSMENTS Fee $AUD

Assessment of Sea Service for persons applying for an AMSA Certificate of Competency or
recognition of a Certificate of Competency as a Master, Deck Officer or Engineer Officer 168
Oral Examination for Certificate of Competency – STCW 78 (as amended) 544
Assessment of marine qualifications for immigration purposes 472

CERTIFICATES / LICENCES / ENDORSEMENTS

Processing of application for the issue and revalidation of a Certificate of Safety Training 112
Processing of application for the issue of a Certificate of Proficiency - Marine Cook 112
Processing of application for the initial issue of a Certificate of Competency or
Certificate of Proficiency 190
Processing of application for the initial issue of a Certificate of Recognition of Competency
(including TTMRA) or Proficiency or Certificate of Equivalence 190
Processing of application for the revalidation or replacement of a Certificate of Competency
or Certificate of Recognition or Certificate of Proficiency or Certificate 1 Equivalence 136
Processing of application for endorsements to an active Certificate 112
Processing of application for the initial issue of, revalidation or replacement of, a GMDSS
Certificate or Certificate of Recognition of GMDSS 112
Processing of application for the issue of a Seafarer’s Service Book 112
Additional charge for transmission of documents other than by regular mail, such as fax,
email, or courier 80

Total amount to be paid (Australian Dollars only) $

Credit card type: Card holder’s name (as it appears on the card)
Mastercard VISA
Credit card number Expiry date Card holders signature Date
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AMSA WILL NOT ACCEPT THIS FORM VIA EMAIL OR FAX

AMSA161 (5/19)