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Appendix-A
[See sub-rule (1) of rule 3]

Application For Registry of a Fishing Boat

To,
The Registrar of Fishing Boats,

Port

Sir,

I/ We of being the owner of fishing boat called

the \
hereby request that the said fishing boat be registered in
my/our names/s and a Certificate of Registry be issued to me / us.

1. Details of Owner(s) of the said fishing boat are as under follows:

Permanent residence or Share (s)
Na me Occupation
principa! place of business held
a

} Bank tr
Company tr
2. Category of the ownership: lnd ividua I !
Co-operative Society n
Government n
3. Area of operation:
4. Particulars of the fishing boat:
a Name and address of building yard
b Port of Previous Registry (if any)
c Details of Previous Mortgages (if any)
d Year of build / re-build of Fishing boat
E Motorized n non-motorized X Open ESemi
e Type of vessel
DeckedEDeck Fitted with an auxiliary engine
f Hull material n Wood n FiberglassI Steeltr Composite
o Tonnage Grdss: Registered:
b

h Details of Fishing gear

Page 1 of 2 Effective date: 15-09-2021 Rev.0U2021

 Trsrrn f* ffi.

Engine Room Cargo

Dimension: Hull
(if fitted) Space
a Length overall
b Length (m)
c Breadth (m)
d Depth (m)
Engine details

a Type of Engine I lnboard E Outboard

b Make c Year of Make
d Engine No e Engine Power

f
Other details (RPM/Length of Stroke /
Diameter of Cylinder), if available.
g Name & address of manufacturer
5. Communicationequipment:
A Maritime Mobile Station ldentification (MMSt) No (if allotted)
Item (if fitted) Make Model
b Automatic ldentification System (AlS)
c Emergency Position lndication Radio Beacon (EPIRB)
d Search& Rescue Transponders (SART)
e Other Com munication eq uipment
f VMS

5. Number of crew including Master:

7. The following documents are enclosed herewith:
a Declaration of ownership
b Builder's certificate (in respect of registration of new vessel) or Bilt of sale, if purchased.
8. I / Wdrequest that a name for the fishing vessets be approved from the fottowing:
1

Place

Date

Signature or Left thumb impression of the owner

Page 2 of 2 Effective date: 15-09-202 L Rev. Ot/202t