Form of Safety Radio Certificate for Cargo Ships
Clasification Society 2024 - Version 9.40
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Form of Safety Radio Certificate for Cargo Ships

CARGO SHIP SAFETY RADIO CERTIFICATE
   
This Certificate shall be supplemented by a Record of Equipment for Cargo Ship Safety Radio (Form R)
   
(Official seal) (State)
   
Issued under the provisions of the
INTERNATIONAL CONVENTION FOR THE SAFETY OF LIFE
AT SEA, 1974, as modified by the Protocol of 1988 relating thereto
   
under the authority of the Government of
   
_______________________________
(name of the State)
   
by _______________________________
(person or organization authorized)
   
Particulars of ship footnote
Name of ship ........................................................................................................................................
Distinctive number or letters ................................................................................................................
Port of registry ......................................................................................................................................
Gross tonnage .....................................................................................................................................
Sea areas in which ship is certified to operate (regulation IV/2) .........................................................................................................
IMO Numberfootnote .........................................................................................................................................
Date on which keel was laid or ship was at a similar stage of construction or, where applicable, date on which work for a conversion or an alteration or modification of a major character was commenced.......................................................................................
   
THIS IS TO CERTIFY:
1 That the ship has been surveyed in accordance with the requirements of regulation I/9 of the Convention.
2 That the survey showed that:
2.1 the ship complied with the requirements of the Convention as regards radio installations;
2.2 the functioning of the radio installations used in life-saving appliances complied with the requirements of the Convention.
3 That an Exemption Certificate has/has notfootnote been issued.
   
This certificate is valid until ....................................................................footnote subject to the periodical surveys in accordance with regulation I/9 of the Convention.
   
Completion date of the survey on which this certificate is based: .................................... (dd/mm/yyyy)
 
Issued at ..............................................................................................................................................
(Place of issue of certificate)
   
.............................................. ..........................................................
(Date of Issue) (Signature of authorized official issuing the certificate)
   
(Seal or stamp of the issuing authority, as appropriate)
   
Endorsement for periodical surveys
THIS IS TO CERTIFY that, at a survey required by regulation I/9 of the Convention, the ship was found to comply with the relevant requirements of the Convention.
   
Periodical survey: Signed: ...............................................................
  (Signature of authorized official)
  Place: .................................................................
  Date: ..................................................................
  (Seal or stamp of the authority, as appropriate)
   
Periodical survey: Signed: ...............................................................
  (Signature of authorized official)
  Place: .................................................................
  Date: ..................................................................
  (Seal or stamp of the authority, as appropriate)
   
Periodical survey: Signed: ...............................................................
  (Signature of authorized official)
  Place: .................................................................
  Date: ..................................................................
  (Seal or stamp of the authority, as appropriate)
   
Periodical survey: Signed: ...............................................................
  (Signature of authorized official)
  Place: .................................................................
  Date: ..................................................................
  (Seal or stamp of the authority, as appropriate)
   
Periodical survey in accordance with regulation I/14(h)(iii)
THIS IS TO CERTIFY that, at a periodical survey in accordance with regulation I/14(h)(iii) of the Convention, the ship was found to comply with the relevant requirements of the Convention.
   
  Signed: ...............................................................
  (Signature of authorized official)
  Place: .................................................................
  Date: ..................................................................
  (Seal or stamp of the authority, as appropriate)
   
Endorsement to extend the certificate if valid for less than 5 years where regulation I/14(c) applies
The ship complies with the relevant requirements of the Convention, and this certificate shall, in accordance with regulation I/14(c) of the Convention, be accepted as valid until .......................................................................
   
  Signed: ...............................................................
  (Signature of authorized official)
  Place: .................................................................
  Date: ..................................................................
  (Seal or stamp of the authority, as appropriate)
   
Endorsement where the renewal survey has been completed and regulation I/14(d) applies
The ship complies with the relevant requirements of the Convention, and this certificate shall, in accordance with regulation I/14(d) of the Convention, 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 survey or for a period of grace where regulation I/14(e) or I/14(f) applies
This certificate shall, in accordance with regulation I/14(e) / I/14(f) footnote of the Convention, be accepted as valid until .......................................................................
   
  Signed: ...............................................................
  (Signature of authorized official)
  Place: .................................................................
  Date: ..................................................................
  (Seal or stamp of the authority, as appropriate)
   
Endorsement for advancement of anniversary date where regulation I/14(h) applies
In accordance with regulation I/14(h) of the Convention, the new anniversary date is .......................................................................
   
  Signed: ...............................................................
  (Signature of authorized official)
  Place: .................................................................
  Date: ..................................................................
  (Seal or stamp of the authority, as appropriate)
   
In accordance with regulation I/14(h) of the Convention, the new anniversary date is .......................................................................
   
  Signed: ...............................................................
  (Signature of authorized official)
  Place: .................................................................
  Date: ..................................................................
  (Seal or stamp of the authority, as appropriate)
Parent topic: Appendix - Certificates relating to the Protocol of 1988
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