Appendix to Part A
Clasification Society 2024 - Version 9.40
Statutory Documents - IMO Publications and Documents - International Codes - ISPS Code - International Code for the Security of Ships and of Port Facilities - Annex - International Code for the Security of Ships and of Port Facilities - Part A - Mandatory requirements regarding the provisions of chapter XI-2 of the Annex to the International Convention for the Safety of Life at Sea, 1974, as amended - Appendix to Part A

Appendix to Part A

Parent topic: Part A - Mandatory requirements regarding the provisions of chapter XI-2 of the Annex to the International Convention for the Safety of Life at Sea, 1974, as amended

Appendix 1

Table 1. Form of the International Ship Security Certificate

Form of the International Ship Security Certificate
INTERNATIONAL SHIP SECURITY CERTIFICATE
(official seal) (State)
Certificate Number .................................................
Issued under the provisions of the
INTERNATIONAL CODE FOR THE SECURITY OF SHIPS AND OF PORT FACILITIES (ISPS CODE)
under the authority of the Government of
___________________________________________
(name of State)
by _____________________________________________________________________________________________________
(person(s) or organization authorized)
Name of ship :...............................................................................................................................................................................................................................................................
Distinctive number or letters :.......................................................................................................................................................................................................................................
Port of registry :............................................................................................................................................................................................................................................................
Type of ship :.................................................................................................................................................................................................................................................................
Gross tonnage :............................................................................................................................................................................................................................................................
IMO Number :................................................................................................................................................................................................................................................................
Name and address of the Company :..........................................................................................................................................................................................................................
Company identification number :..................................................................................................................................................................................................................................
         
THIS IS TO CERTIFY:
1 that the security system and any associated security equipment of the ship has been verified in accordance with section 19.1 of part A of the ISPS Code;
2 that the verification showed that the security system and any associated security equipment of the ship is in all respects satisfactory and that the ship complies with the applicable requirements of chapter XI-2 of the Convention and part A of the ISPS Code;
3 that the ship is provided with an approved ship security plan.
Date of initial / renewal verification on which this certificate is based .............................................................................
This Certificate is valid until ........................................................................................................................................................ subject to verifications in accordance with section 19.1.1 of part A of the ISPS Code.
Issued at .....................................................................................................................................................................................................................................................................
(Place of issue of the Certificate)
Date of issue ............................................ ......................................................................................................................................
  (Signature of the duly authorized official issuing the Certificate)
   
(Seal or stamp of issuing authority, as appropriate)

Table 2. Endorsement For Intermediate Verification

Endorsement for intermediate verification
THIS IS TO CERTIFY that at an intermediate verification required by section 19.1.1 of part A of the ISPS Code the ship was found to comply with the relevant provisions of chapter XI-2 of the Convention and part A of the ISPS Code.
   
Intermediate verification Signed: ..............................................................................................
    (Signature of authorized official)
    Place: ................................................................................................
    Date: .................................................................................................
         
    (Seal or stamp of the authority, as appropriate)
         
Endorsement for additional verifications*
         
Additional verification Signed: ..............................................................................................
    (Signature of authorized official)
    Place :................................................................................................
    Date: .................................................................................................
         
    (Seal or stamp of the authority, as appropriate)
 
Additional verification Signed: ..............................................................................................
    (Signature of authorized official)
    Place :................................................................................................
    Date :.................................................................................................
         
    (Seal or stamp of the authority, as appropriate)
   
Additional verification Signed: ..............................................................................................
    (Signature of authorized official)
    Place: ................................................................................................
    Date :.................................................................................................
         
    (Seal or stamp of the authority, as appropriate)
         
*This part of the certificate shall be adapted by the Administration to indicate whether it has established additional verifications as provided for in section 19.1.1.4.

Table 3. Additional Verification

Additional verification in accordance with SECTION A/19.3.7.2of the ISPS Code
THIS IS TO CERTIFY that at an additional verification required by section 19.3.7.2 of part A of the ISPS Code the ship was found to comply with the relevant provisions of chapter XI-2 of the Convention and part A of the ISPS Code.
 
  Signed:..............................................................................................
    (Signature of authorized official)
    Place: ................................................................................................
    Date: .................................................................................................
 
    (Seal or stamp of the authority, as appropriate)
 
Endorsement to extend the certificate is valid for less than 5 years where section A/19.3.3 of the ISPS Code applies
The ship complies with the relevant provisions of part A of the ISPS Code, and the Certificate shall, in accordance with section 19.3.3 of part A of the ISPS Code, be accepted as valid until ..............................
 
  Signed: ..............................................................................................
    (Signature of authorized official)
    Place: ................................................................................................
    Date: .................................................................................................
 
    (Seal or stamp of the authority, as appropriate)
 
Endorsement where the renewal verification has been completed and section A/ 19.3.4 of the ISPS Code applies
The ship complies with the relevant provisions of part A of the ISPS Code, and the Certificate shall, in accordance with section 19.3.4 of part A of the ISPS Code, be accepted as valid until ..............................
 
  Signed: ..............................................................................................
    (Signature of authorized official)
    Place: ................................................................................................
    Date: .................................................................................................
 
    (Seal or stamp of the authority, as appropriate)
         
Endorsement to extend the validity of the certificate until reaching the port of verification where section A/19.3.5 of the ISPS Code applies or for a period of grace where sectioA/19.3.6 of the ISPS Code applies
This Certificate shall, in accordance with section 19.3.5 / 19.3.6* of part A of the ISPS Code, be accepted as valid until ..............................
   
  Signed: ..............................................................................................
    (Signature of authorized official)
  Place: ................................................................................................
  Date: .................................................................................................
 
    (Seal or stamp of the authority, as appropriate)
 
Endorsement for advancement of expiry date where section A/19.3.7.1 of the ISPS Code applies
In accordance with section 19.3.7.1 of part A of the ISPS Code, the new expiry date** is ..............................
   
  Signed: ..............................................................................................
    (Signature of authorized official)
  Place: ................................................................................................
  Date: .................................................................................................
 
    (Seal or stamp of the authority, as appropriate)
 
* Delete as appropriate.
** In case of completion of this part of the certificate the expiry date shown on the front of the certificate shall also be amended accordingly.

Appendix 2

Table 1. Interim International Ship Security Certificate

Form of the International Ship Security Certificate
         
INTERIM INTERNATIONAL SHIP SECURITY CERTIFICATE
(official seal) (State)
Certificate Number.................................................................
Issued under the provisions of the
INTERNATIONAL CODE FOR THE SECURITY OF SHIPS AND OF PORT FACILITIES (ISPS CODE)
under the authority of the Government of
______________________________________________________________________
(name of State)
by _____________________________________________________________________________________________________
(person(s) or organization authorized)
Name of ship ...................................................................
Distinctive number or letters ...................................................................
Port of registry ...................................................................
Type of ship ...................................................................
Gross tonnage ...................................................................
IMO Number ...................................................................
Name and address of the Company ...................................................................
Company identification number ...................................................................
Is this a subsequent, consecutive Interim Certificate? Yes/ No*
If Yes, date of issue of initial Interim Certificate: ...................................................................
         
THIS IS TO CERTIFY THAT the requirements of section A/19.4.2 of the ISPS Code have been complied with.
 
This Certificate is issued pursuant to section A/19.4 of the ISPS Code.
 
This Certificate is valid until ...............................................................................................
Issued at ............................................................................................................................
(Place of issue of the Certificate)
Date of issue : ............................................ .......................................................................................
  (Signature of the duly authorized official issuing the Certificate)
   
(Seal or stamp of issuing authority, as appropriate)
*Delete as appropriate
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