Bare-Boat Chartered Vessels

DETAILS OF BARE-BOAT CHARTERER (Canadian address)

Name and address

Telephone number

Cell number

Fax number

E-mail address

Certificate in (select one)

English
French

STATE AS FOLLOWS (select one)

INDIVIDUAL
I am a Canadian citizen or a permanent resident within the meaning of Subsection 2(1) of the Immigration and Refugee Protection Act.
CORPORATION
A corporation incorporated under the laws of Canada and existing as per those laws at the time of this application.
A corporation incorporated under the laws of a Province and existing as per those laws at the time of this application.
NOTE: Partnerships are note accepted.

INDIVIDUAL

Signed at

Signature of Bare-boat Charterer (Authorized Representative)

Date Application Signed

CORPORATION

I

state that I have authority to bind

I also state that

is the name of a corporation which legally exists at the date of this Application:

as per the laws of Canada; OR
as per the laws of (province/state)

Name of province/state

This Application must be signed by the Bare-boat Charterer (Authorized Representative) who is an Officer or Director of the corporation who has the authority to bind the corporation. Pursuant to Sections 51(2) and 75.01(2) of the Canada Shipping Act, 2001 applicants may be required to provide additional information as requested by the Chief Registrar.

I understand that it is an offence for a person to knowingly make a false or misleading statement in writing and that the penalty can be a fine or imprisonment or both if found guilty in a court of law (Section 37 of the Canada Shipping Act, 2001).

Signature of Bare-boat Charterer (Authorized Representative)

Date

Contact Information

First Name*

Last Name*

Telephone Number*

Facsimile

Email*

Enter Email Confirm Email

APPLICATION FOR BARE-BOAT CHARTER REGISTRY

Price:

APPLICATION FOR BARE-BOAT CHARTER REGISTRY

Price:

Please select any additional services you wish to have processed

Priority Request/Rush Processing

Priority Request/Rush Processing

Price:

Total

$ 525.00 CAD

Authorization*

I agree to pay the above total amount according to the card issuer agreement and hereby authorize the charge for the total amount above for the processing of selected Transport Canada documents. I understand that my application will be processed in the order in which it is received by National Vessel Registry Center Corp, a third-party fee for service company. I understand that application and processing fees are non-refundable as per National Vessel Registry Center Corp's no refund policy. I understand that submitting another application for vessel documentation will supersede the current/pending application for that vessel.

Payment Information

American Express

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MasterCard

Visa

Card Number Expiration Date Security Code Cardholder Name

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Billing Address

Address*

Street Address Address Line 2 City ZIP / Postal Code (required for Canadian [A1A 1A1] and US [#####] only)

State/Province/Region*

Other*

Country*

Is your shipping address different from the one above?

Shipping Address

Address*

Street Address Address Line 2 City ZIP / Postal Code (required for Canadian [A1A 1A1] and US [#####] only)

State/Province/Region*

Other*

Country*

By clicking submit you agree to these Terms and Conditions.

APPLICATION FOR BARE-BOAT CHARTER REGISTRY

Step 1 of 2

IMPORTANT INFORMATION

VESSEL NAME AND PORT OF REGISTRY

PARTICULARS OF VESSEL

DETAILS OF UNDERLYING FOREIGN REGISTRATION

DETAILS OF BARE-BOAT CHARTERER (Canadian address)

INDIVIDUAL

CORPORATION

Contact Information

Billing Address

Shipping Address