INTERNATIONAL FISHING
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VESSEL SAFETY CERTIFICATE
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This Certificate shall be supplemented by a
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Record of Equipment
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(Official seal)
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(State)
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Issued under the provisions of the
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TORREMOLINOS PROTOCOL OF 1993 RELATING TO
THE
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TORREMOLINOS CONVENTION FOR THE SAFETY OF
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FISHING VESSELS, 1977
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under the authority of the Government of
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____________________________________
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(name of the State)
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____________________________________
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by
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(person or organization authorized)
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Particulars of vesselfootnote
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Name of vessel . . . . . . . . . . . . . . . . . . .
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Distinctive number or letters . . . . . . . . . . .
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Port of registry . . . . . . . . . . . . . . . . . .
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Length (L)2
footnote. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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.
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Date of building or major conversion contract . . .
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Date on which keel was laid or vessel was at a
similar stage of construction in accordance with regulation I/2(1)(c)(ii) or (1)(c)(iii) . . . . . . .
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Date of delivery or completion of major conversion .
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THIS IS TO CERTIFY:
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1
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That the vessel has been surveyed in accordance with
the requirements of regulation I/6.
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2
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That the survey showed that:
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.1
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the condition of the hull, mahcinery and equipment, as
defined in the above regulation was in all respects satisfactory and that
the vessel complied with the applicable requirements;
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.2
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the maximum permissible operating draught associated
with each operating condition for the vessel is contained in the approved
stability booklet dated . . . . . . . . . . . . . . . . . . . . . . . . . .
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3
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That an Exemption Certificate has/has notfootnote been issued.
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This certificate is valid until . . . . . . . . . . .
. . . . . . . . . . . . . subject to surveys in accordance with regulation
I/6(1)(b)(ii), (b)(iii) and (c)
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Issued at . . . . . . . . . . . . . . . . . . . . .
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(Place of issue of certificate)
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(Date of issue)
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(Signature of authorized official issuing the certificate)
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(Seal or stamp of the issuing authority, as appropriate)
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ENDORSEMENT TO EXTEND THE VALIDITY OF THE
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CERTIFICATE FOR A PERIOD OF GRACE WHERE
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REGULATION I/11(1) APPLIES
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This certificate shall, in accordance with regulation
I/11(1), be accepted as valid until . . . . . . . . . . . . . . .
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Signed; . . . . . . . . . . . . . . . . . . . . . . .
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(Signature of authorized official)
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Place: . . . . . . . . . . . . . . . . . . . . . . . .
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Date: . . . . . . . . . . . . . . . . . . . . . . . .
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(Seal or stamp of the authority, as appropriate)
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ENDORSEMENT TO EXTEND THE VALIDITY OF THE
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CERTIFICATE UNTIL REACHING THE PORT
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OF SURVEY OR FOR A PERIOD OF GRACE
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WHERE REGULATION I/11(2) OR
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REGULATION I/11(4) APPLIES
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This certificate shall, in accordance with regulation
I/11(2)/regulation I/11(4)
footnote, be accepted as valid until . . . . . . . . . . . . . . .
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Signed; . . . . . . . . . . . . . . . . . . . . . . .
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(Signature of authorized official)
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Place: . . . . . . . . . . . . . . . . . . . . . . . .
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Date: . . . . . . . . . . . . . . . . . . . . . . . .
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(Seal or stamp of the authority, as appropriate)
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ENDORSEMENT FOR PERIODICAL SURVEYS
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Equipment survey
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THIS IS TO CERTIFY that, at a survey required by
regulation I/6(1)(b)(iii), the vessel was found to comply with
the relevant requirements.
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Signed; . . . . . . . . . . . . . . . . . . . . . . .
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(Signature of authorized official)
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Place: . . . . . . . . . . . . . . . . . . . . . . . .
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Date: . . . . . . . . . . . . . . . . . . . . . . . .
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(Seal or stamp of the authority, as appropriate)
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Radio surveys
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THIS IS TO CERTIFY that, at a survey required by
regulation I/6(1)(b)(iii), the vessel was found to comply with
the relevant requirements.
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First periodical radio survey:
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Signed; . . . . . . . . . . . . . . . . . . . . . . .
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(Signature of authorized official)
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Place: . . . . . . . . . . . . . . . . . . . . . . . .
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Date: . . . . . . . . . . . . . . . . . . . . . . . .
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(Seal or stamp of the authority, as appropriate)
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Second periodical radio survey:
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Signed; . . . . . . . . . . . . . . . . . . . . . . .
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(Signature of authorized official)
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Place: . . . . . . . . . . . . . . . . . . . . . . . .
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Date: . . . . . . . . . . . . . . . . . . . . . . . .
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(Seal or stamp of the authority, as appropriate)
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Third periodical radio survey:
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Signed; . . . . . . . . . . . . . . . . . . . . . . .
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(Signature of authorized official)
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Place: . . . . . . . . . . . . . . . . . . . . . . . .
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Date: . . . . . . . . . . . . . . . . . . . . . . . .
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(Seal or stamp of the authority, as appropriate)
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ENDORSEMENT FOR INTERMEDIATE SURVEYS
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THIS IS TO CERTIFY that, at a survey required by
regulation I/6(1)(c), the vessel was found to comply with the
relevant requirements.
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Signed; . . . . . . . . . . . . . . . . . . . . . . .
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(Signature of authorized official)
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Place: . . . . . . . . . . . . . . . . . . . . . . . .
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Date: . . . . . . . . . . . . . . . . . . . . . . . .
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(Seal or stamp of the authority, as appropriate)
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