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Vigilate

Government of The British Virgin Islands

MERCHANT SHIPPING ACT 2001

Virgin Island

PROPOSED NAME FOR A BRITISH SHIP

NOTE:Please complete sections 1 & 2 only in BLOCK LETTERS

SECTION 1

1. VESSEL DETAILS

Proposed Name of Ship and alternative name(s) in order of preference(in case your first choice cannot be authorized) 1
2
3
4

NOTE: once a name has been approved it may not be possible to change to an alternative name.

If the ship is new please give:

Name of builder
Address of builder
Yard number allocated to this ship

If the ship is not new and if the ship has been at any time on the British Register please give:

The last British name
If available the official number

If the ship is not British, please give:

Name
Nationality
IMO/Official Number
Tonnage (GRT)
Length
Method of propulsion Steam Motor Sail
Port of registry
Type of vessel Pleasure Commercial Passenger Cargo Other
Intended date of registry

SECTION 2

2. DETAILS OF OWNER(S)

Please enter below the names, addresses and nationalities of all the owners of the ship. If you need more space please make another copy of this page and continue. Your own details should be entered last.

Name Name
Address Addresss
Nationality Nationality
Name Name
Address Addresss
Nationality Nationality
Name of Applicant Address of Applicant
Signature of Applicant
Telephone No.
Fax No.
E-mail Date

SECTION 3

3. To be completed by Registrar only

I certify that the name

is not already the name of a nd has/not been allowed. registered British Ship, or so similar to a registered name as to be calculated to deceive, have lapsed. The authority may however be renewed for another such period upon application to the Registrar.

If the ship is not registered within 6 months (180 days) of th e date of this certificate, this authority will be considered to have lapsed. The authority may however be renewed for another such period upon application to the Registrar.

Registrar of Shipping Date of Certificate
Port of Registry Signature of Registrar

When you have completed sections 1 & 2 please return this form to:
Virgin Islands Shipping Registry
Sebastian's Building, Administration Drive
Road Town, Tortola
British Virgin Islands
Tel. (284) 468-2902/29 . (284) 468-291

FORMERLY ROS 8SR101-03 (03/10)