Change of Vessel Name or Hailing Port

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ANY ADDITIONAL CHANGES APART FROM VESSEL NAME CHANGE OR HAILING PORT CHANGE WILL REQUIRE ADDITIONAL FEES.

NOTE: FILING THIS APPLICATION DOES NOT ENTITLE A VESSEL TO DOCUMENTATION OR TO ANY CHANGES DESIRED ON A CERTIFICATE OF DOCUMENTATION. OFFICIAL NUMBERS DESIGNATED ON THE BASIS OF THIS APPLICATION ARE NOT TRANSFERABLE. ONLY A CURRENT CERTIFICATE OF DOCUMENTATION IS VALID FOR VESSEL OPERATION.

IF YOUR USCG (CERTIFICATE OF DOCUMENTATION) IS PAST 30 DAYS BEYOND ITS DATE OF EXPIRATION, YOU MUST REINSTATE YOUR DOCUMENTATION. PLEASE FOLLOW THIS LINK TO "REINSTATE" YOUR (CERTIFICATE OF DOCUMENTATION)

A-1. CURRENT VESSEL NAME AND OFFICIAL # *

A-2. NEW VESSEL NAME

Insert name by which you wish the vessel to be known. Only standard Alpha and Numeric Characters in the vessel name will appear on the Certificate of Documentation. Click icon for attachment if application covers multiple vessels.

Please select from the following:

I already own this vessel
I purchased this vessel from another owner
This vessel was newly built

B-1. HAILING PORT INCLUDING STATE

B-2. NEW HAILING PORT INCLUDING STATE (TO BE MARKED ON VESSEL)

Insert name of place and state exactly as it is or will be marked on the vessel. The hailing port must be a place in the United States. Commonly used abbreviations such as ‘NY, NY’ are acceptable.

C. OFFICIAL # (IF AWARDED)

Please enter the Official Number (O/N) awarded by the Coast Guard for all but Initial Issue cases.

Please Confirm Official # *

D. HULL ID # (IF ANY)

Please enter Hull Identification Number (HIN) as assigned in accordance with 33 CFR 81.

E. IMO # (IF ANY)

Please enter International Maritime Organization Number (IMO), if any.

F. NAME OF MANAGING OWNER, E-MAIL ADDRESS, TELEPHONE NUMBER:

Name, e-mail address, and telephone number of the owner to whom the Coast Guard should direct correspondence and their Social Security Number (SSN), or Tax Identification Number (TIN). Only an owner, or part owner, can be the managing owner. For vessels owned by a corporation, the corporation is considered the managing owner. For a trust arrangement, the trustee will be the managing owner. For a Partnership or a LLC, the name of the Partnership or the LLC should be shown.

NAME OF MANAGING OWNER

E-MAIL ADDRESS OF MANAGING OWNER

TELEPHONE NUMBER OF MANAGING OWNER

SOCIAL SECURITY OR TAX ID NUMBER (46 USC 12104): (SECURE FORM)

IS THIS NUMBER YOUR SOCIAL SECURITY NUMBER OR TAX ID NUMBER?

SOCIAL SECURITY NUMBER
TAX ID NUMBER

G. ENTER PHYSICAL ADDRESS OF MANAGING OWNER (REQUIRED – 46 CFR 67.113)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

ENTER MAILING ADDRESS OF MANAGING OWNER (IF DIFFERENT THAN PHYSICAL ADDRESS – E.G. , P.O. BOX)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

H. Are There Other Persons and/or Entities That Own an Interest in the Vessel?

Include all persons/entities (other than managing owner) who own an interest in the vessel below.

H. NAME(S) OF OTHER OWNER(S)

Please enter all persons/entities (other than managing owner) who own an interest in the vessel. If no owners other than the managing owner apply, please leave this field blank. Please click the icon for additional attachments if application covers multiple owners.

Is there an active lien or mortgage on this vessel?

Is it satisfied?

An Abstract of Title will be added to establish if the lien or mortgage has been satisfied.

Social Security Number (Individual)

If you are using a Social Security Number, please leave Tax ID Number blank.

Tax ID Number (Business Entity)

If you are using a Tax ID Number, please leave Social Security Number blank.

I. PURPOSE OF APPLICATION.

Please check all applicable blocks to illustrate purpose of this application. If this vessel has never been documented, please check Block #5 and provide ALL requested information known about the vessel's place and year of build, hull material, approximate length and previous names and numbers. If this information is unknown, please indicate below.

1. TRANSFER/EXCHANGE OF CERTIFICATE OF DOCUMENTATION
2. REPLACEMENT OF LOST, WRONGFULLY WITHHELD OR MUTILATED CERTIFICATE OF DOCUMENTATION
3. RE-INSTATEMENT OF CERTIFICATE OF DOCUMENTATION FOLLOWING FAILURE TO RENEW
4. RETURN TO DOCUMENTATION FOLLOWING DELETION.
5. APPLICATION FOR OFFICIAL NUMBER AND FIRST CERTIFICATE OF DOCUMENTATION.
6. CHANGE OF VESSEL NAME OR HAILING PORT

VESSEL NAME WHEN LAST DOCUMENTED:

HULL MATERIAL:

WOOD
STEEL
FIBROUS REINFORCED PLASTIC
ALUMINUM
CONCRETE
OTHER

Describe

ARE THERE ANY ACTIVE LIENS OR MORTGAGES ON THIS VESSEL? *

No, there are no active liens or mortgages on this vessel
Yes, there is an active lien or mortgage on this vessel

J. ENDORSEMENTS FOR WHICH APPLICATION IS MADE

RECREATIONAL
FISHERY
COASTWISE
REGISTRY
COASTWISE – BOWATERS ONLY (CERTIFICATE ON FILE)
COASTWISE – OIL SPILL RESPONSE ONLY (LETTER OF QUALIFICATION ON FILE)
COASTWISE UNDER CHARTER TO AN ENTITY QUALIFIED TO ENGAGE IN COASTWISE TRADE (COPY OF CHARTER ON FILE)

Please check the appropriate block(s) to indicate all endorsement(s) sought on this application.

K. PRIMARY SERVICE & HORSEPOWER:

Please select only ONE service for which the vessel will be primarily used and insert horsepower as well.

HORSEPOWER

Step 1 of 3

PRIORITY REQUEST / RUSH PROCESSING

PREFERRED MORTGAGE

SATISFACTION OF MORTGAGE