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Vigilate

Government of The British Virgin Islands

MERCHANT SHIPPING ACT 2001 REGISTRY OF SHIPPING

Virgin Island

APPOINTMENT OF AUTHORISED OF FICER FOR A BODY CORPORATE

Note: Please complete in BLOCK LETTERS

Name of Ship
Official Number/IMO Number
Number, Year and Port of Registry (if applicable)
Full Company Name
Full address of place of business

The following officer(s) of the Company are hereby authorised to make and sign all declarations of ownership and/or other documents for and on behalf of the said Company, as required under provisions of The Merchant Shipping Act 2001

Full name(s) of Authorised Officer(s) Specimen Signature Title

The common seal of the Company was affixed to this authority in the presence of:

Director Full Name Signature
*Director / Secretary
Authorised signatory
Date

*Delete as appropriate

NOTE: WHEN THERE IS NO COMPANY SEAL THE AUTHORITY MUST BE NOTARIZED

Please send this completed form and supp
orting documents to the Registrar.
Virgin Islands Shipping Registry
Sebastian’s Building, Administration Drive
Road Town, Tortola
British Virgin Islands
Tel. (284) 468-2902/2903 Fax. (284) 468-2913

FORMERLY ROS 3SR101-03 (03/10)