Transmission on Death/Bankruptcy

Official number
Name of vessel
Port of registry
INDIVIDUAL
Signature
DECLARED BEFORE ME AT
Signature
Date Declaration signed
YYYY dash MM dash DD
Name and title
Address
CORPORATION
I
state that I have authority to bind
I also state
is the name of a corporation which legally exists at the date of this Declaration:
- as per the laws of Canada; OR
- as per the laws of (province/state)
Name of province/state
This Declaration must be signed by any 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 Officer or Director
DECLARED BEFORE ME AT
Signature
Date Declaration signed
YYYY dash MM dash DD
Name and title
Address
INDIAN BAND
Name of Indian Band
Signature
Name of person signing above
DECLARED BEFORE ME AT
Signature
Date Declaration signed
YYYY dash MM dash DD
Name and title
Address
Contact Information
First Name*
Last Name*
Telephone Number*
Facsimile Number
Email*
Enter Email Confirm Email
APPLICATION FOR TRANSMISSION DEATH/BANKRUPTCY
Price:
APPLICATION FOR TRANSMISSION DEATH/BANKRUPTCY
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

American Express
Discover
MasterCard
Visa
Supported Credit Cards: American Express, Discover, MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name
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- *My card information is not working; I would like to continue my submission and receive a call from a specialist regarding payment.
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.

DECLARATION OF TRANSMISSION

Step 1 of 2

DETAILS OF TRANSMISSION - DECLARE AS FOLLOWS (select one)

INDIVIDUAL

CORPORATION

INDIAN BAND

Contact Information

Billing Address

Shipping Address