bareboat charter register - mobilit.belgium.be · page / 2012no 95 (1) please tick relevant...

Page / 2012No 95 –

KINGDOM OF BELGIUM_________

BAREBOAT CHARTER REGISTER

FEDERAL PUBLIC SERVICE____ MOBILITY AND TRANSPORT

Posthoflei 5B – 2600 BERCHEM

Phone. : 0032/(0)3/229 00 48 E-mail : [email protected]

(for completion by Belgian Ship Registry)

APPLICATION FOR REGISTRATION APPLICATION FOR EXTENSION OF

NOTIFICATION OF CHANGES

(1)REGISTRATION

–

–

Capacity of applicant / notifier (1) :

according to attached power of attorney

B

A

C

E

G

F

H

I

K

Name of vessel :

(1) Please tick relevant box. (2) Meaning the indvidual who signs the application/notification. (3) Only to be completed in case of notification of changes or in case of application for extension of the registration. (4) Only to be completed in case of a) notification of changes having no bearing on these particulars or b) application for extension of registration. In case of an application for registration, only the appropriate page hereafter has to be completed. In case of a notification of changes regarding these particulars, only the appropriate page hereafter has to be completed. (5) To be completed in the event of this period being shorter than the charter period mentioned in box J.

Date of application / notification :

Phone : Mobile :

Last name / family name : First names :Applicant / Notifier (2) :

Fax : Email :

Year of build : Place of build :Particulars of vessel (4) :

Registration number of vessel (3) :

Particulars of owner (4) : Name :Adress / registered office :

Particulars of bareboat charterer (4) : Name :Address / registered office :

Address for service in Belgium : Name :Address / registered office :

Primary register : Country :Register number :

D

L

M

N

O

Belgian Ship Registry

of :

JCharter party :Start date :End date :

Date of contract :Date of commencement :Date of termination :

Requested period of bareboat charter registration (5) :

Address :

bareboat chartererauthorized shareholder ; director ; managing director ; authorized representative

representative of bareboat charterer the commercial company - the body corporate that charters the vessel

Place of application / notification :

Signature of applicant / notifier :

Page / 2012No 95 –

PARTICULARS OF VESSEL

A

C

B

D

E F

G H

I J

K L

M N

O P

R

(1) Please tick relevant box/indication. (2) In case of notification of changes, only the particulars that are changed need to be completed.


APPLICATION FOR REGISTRATION APPLICATION FOR EXTENSION OF(1)

(2)REGISTRATION

–

–

Name :

Place of build :

Type :

Building number : Purpose :

Port of registry : Materials (hull) :

IMO number : Call sign :

Year of build :

Shipyard :

Overall lenght in meter : Overall breadth in meter :

Gross tonnage :

DWT :

Net tonnage :

Engine(s) : S

Type : Power (kW) :

Serial number :Make :

Year of build :

Other specifications :

Number :

Comments : Q

- by owner to charterer : - by ship yard to owner :Date of delivery :

Page / 2012No 95 –

D E

F

G H

I J

K L

M N

O

(1) Please tick relevant box/indication (2) In case of notification of changes, only the particulars that are changed need to be completed. (3) In the event of different persons owning the vessel, a separate page has to be completed and inserted for each of them. If the vessel is owned by married people, a separate page has to be completed for each of them. (4) To be completed only if the principal place of residence is not the same as the domicile.

Shares in vessel :

Husband/wife - Last name/family name : First names :

Domicile : Principal place of residence (4) :

Place and date of birth :

Company registration number :

P

Name :

%

Profession :

Husband/wife - Place and date of birth :

B

INSERTED PAGE

Number of owners :

(3)No.APPLICATION FOR REGISTRATION APPLICATION FOR EXTENSION OF REGISTRATION

NOTIFICATION OF CHANGES (2)

(1)


–

PARTICULARS OF OWNER

INDIVIDUAL

A–

First names :

Nationality : VAT number :

National identification number :

Page / 2012No 95 –

INSERTED PAGE

B

C

D

E

F

G

H

K

J

I

(1) Please tick relevant box/indication. (2) In case of notification of changes, only the particulars that are changed need to be completed. (3) In the event of different persons owning the vessel, a separate page has to be completed and inserted for each of them. (4) For a commercial company under Belgian law the incorporation is effected on the day an extract from the constitution deed (articles of association) is filed with the registrar of the commercial court (commercial companies law, art. 2. § 4). (5) To be completed only if the real place of business is not the same as the place of the registered office.

Shares in vessel :


Real place of business (5) :

Registered office :

Date of incorporation (4) :

A (3)NO;

%

APPLICATION FOR REGISTRATION APPLICATION FOR EXTENSION OF REGISTRATION


(1)


–

Number of owners :PARTICULARS OF OWNER

COMMERCIAL COMPANY - OTHER BODY CORPORATE(1)

–

Name :

Country of incorporation :

Legal form :

Place and date of incorporation :

VAT number :

Page / 2012No 95 –

INSERTED PAGE

PARTICULARS OF BAREBOAT CHARTERERNumber of charterers :

B

C

D E

F

G H

J

K L

M

N O

P

(1) Please tick relevant box/indication. (2) In case of notification of changes, only the particulars that are changed need to be completed. (3) In the event of different charterers operating the vessel, a separate page has to be completed and inserted for each of them. If the vessel is operated by married people, a separate page has to be completed for each of them. (4) To be completed only if the principal place of residence is not the same as the domicile.

Husband/wife - Place and date of birth :

Husband/wife - Last name/family name : First names :

Domicile : Principal place of residence (4) :

I

A (3)No.

Profession :



(1)


INDIVIDUAL

––


Name : First names :

Place and date of birth :

Nationality : VAT number :

National identification number :

Place the vessel is operated from :

Page / 2012No 95 –

Number of charterers :

B

C

D

E

F

G

H

I

J

K

Legal form :

Date of incorporation (4) :

(1) Please tick relevant box/indication (2) In case of notification of changes, only the particulars that are changed need to be completed. (3) In the event of different charterers operating the vessel, a separate page has to be completed and inserted for each of them. (4) For a commercial company under Belgian law the incorporation is effected on the day an extract from the constitution deed (articles of association) is filed with the registrar of the commercial court (commercial companies law, art. 2, § 4). (5) To be completed only if the real place of business is not the same as the place of the registered office. (6) To be completed only if the place of operation is not the same as the place of the registered office. (7) The data valid for the place of operation have to be mentioned; unless the place of operation is the same as the place of the registered office, in which case the data valid for the registered office have to be mentioned.


VAT number :

Place of operation in Belgium from which the operation of vessel is being controlled (6) :

Real place of business (5) :

Registered office :

INSERTED PAGEA (3)NO.

COMMERCIAL COMPANY - OTHER BODY CORPORATE(1)



(1)


PARTICULARS OF BAREBOAT CHARTERER

–

–

(7)

Corporate name :

Country of incorporation :

Place and date of incorporation :

Page / 2012No 95 –

FOR COMPLETION BY THE HEAD OF SERVICE BELGIAN SHIP REGISTRY

______________

Number of lodgment :

Registered / Entered

on :

in the bareboat charter register under registration number :

In full :

Total :

Fee :Cost :

The head of service Belgian Ship Registry,

FOR COMPLETION BY DIRECTORATE-GENERAL SHIPPING (2)

APPLICATION FOR REGISTRATION - APPLICATION FOR EXTENSION OF


(1)

The undersigned, authorized official, herewith consents (1) :

Brussels,

(Signature and capacity)

(1) Please tick relevant box/indication. (2) Does only apply in the event of a new bareboat registration having to be granted or in the event of an already existing bareboat registration to be extended.

Consent to Belgian bareboat registration

Consent to extension of Belgian bareboat registration

(1)

to the bareboat registration in Belgium

to the extension of the bareboat registration in Belgium

–

02-

of the vesssel called :

bareboat charter register - mobilit.belgium.be · page / 2012no 95 (1) please tick relevant...

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