Registration of a Government Vessel

DECLARATION

I, the undersigned,

of the department of ministry of

declare as follows:

The above general description of the vessel(s) is/are correct to the best of my knowledge and belief. The document(s) of title establish ownership to:

Provincial

His Majesty the King in Right of the Province, represented by the Minister of

entitles the department or ministry to be registered as owner of 64 shares of the said vessel under the Canada Shipping Act, 2001, Subsection 46.(3).

In accordance with Subsections 51.(1) and 75.01(2) of the Canada Shipping Act, 2001, an application must be made in the form and manner, include the information and be accompanied by the documents specified by the Chief Registrar. For the purpose of this application, documents of title (e.g. Bill of Sale/receipt, Builder's Certificate or other documentation) exist for each vessel registered individually or in a Fleet and will be retained by the home department for future transfer(s) of ownership of the vessel(s) or as evidence if requested by the Chief Registrar.

Signed at

Signature of owner

Date

TITLE AND ADDRESS OF PERSON SIGNING ON BEHALF OF THE DEPARTMENT OR MINISTRY

Title

Address

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

State/Province/Region*

Country*

PAYMENT INFORMATION - FEDERAL GOVERNMENT ONLY

In addition to our service fee, a fee of $250.00 (per vessel) is applicable and payment must be processed via the InterDepartmental Settlement (IS) process. The government department applying for registration must provide the following information:

Organization code:

Department code:

Reference number:

Contact Information

First Name*

Last Name*

Telephone number*

Facsimile number

Email*

Enter Email Confirm Email

APPLICATION FOR REGISTRATION OF A GOVERNMENT VESSEL

Price:

APPLICATION FOR REGISTRATION OF A GOVERNMENT VESSEL

Price:

Please select any additional services you wish to have processed

Priority Request/Rush Processing

Priority Request/Rush Processing

Price:

Total

$ 0.00 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

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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 and the above authorization of payment.

APPLICATION FOR REGISTRY OF A GOVERNMENT OWNED VESSEL

Step 1 of 2

VESSEL NAME AND PORT OF REGISTRY

PARTICULARS OF VESSEL

DECLARATION

Provincial

TITLE AND ADDRESS OF PERSON SIGNING ON BEHALF OF THE DEPARTMENT OR MINISTRY

PAYMENT INFORMATION - FEDERAL GOVERNMENT ONLY

Contact Information

Billing Address

Shipping Address