rs | ……………… | ……… |
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THIS IS TO CERTIFY that this Record is correct in all respects
Issued at ------------------------------------------------------------
(Place of issue of the Record)
-------------------------- ---------------------------------
(Date of Issue) (Signature of duly authorized
official issuing the Record)
(Seal or stamp of the issuing authority, as
appropriate)
Form C (Safety Certificate for Cargo Ships)
Form of Safety Certificate for Cargo Ships
CARGO SHIP SAFETY CERTIFICATE
This Certificate shall be supplemented by a Record of Equipment
(Form C)
(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 ①
[ ① Alternatively, the particulars of the ship may be placed
horizontally in boxes.]
Name of ship ---------------------------------------------------------
Distinctive number or letters ----------------------------------------
Port of registry -----------------------------------------------------
Gross tonnage --------------------------------------------------------
Deadweight of ship (metric tons)② ----------------------------------
[ ② For oil tankers, chemical tankers and gas carriers only.]
Length of ship (regulation III/3.10) ---------------------------------
Sea areas in which ship is certified to operate (regulation IV/2) ----
IMO Number③ --------------------------------------------------------
[ ③ In accordance with resolution A. 600(15)-IMO Ship Identification
Number Scheme, this information may be included voluntarily.]
Type of ship④
[ ④ Delete as appropriate.]
Oil tanker
Chemical tanker
Gas carrier
Cargo ship other than any of the above
Date on which keel was laid or ship was at a similar stage of
construction or, where applicable, date on which work for 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/8, I/9 and I/10 of the Convention.
2 That the survey showed that:
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