Sender Title*:-- Please select --MrsMr Name*: Company*: Email*: Telephone*: Vessel Reason*:-- Please select --Renewal Trading pattern*: Date of effect*: Vessel Name*: IMO No.*: I hereby declare, that no information concerning the vessel and its owners have changed Crew Position Gender Nationality -- Please select--Master1st Nav Officer2nd Nav Officer3rd Nav Officer4th Nav OfficerChief Eng OfficerChief Eng Officer below 3000 kWChief Eng Officer below 750 kW1st Eng Officer2nd Eng Officer3rd Eng Officer4th Eng. OfficerGas EngineerElect. Eng OfficerElectricianAss. ElectricianNOA/TOABosunAB (Able Seaman)OS (Ordinary Seaman)AB/MotormanAB/OilerAB/CookAB/RepairerAB/GPAB/FitterMotormanMotorman/GPFitterPlumberPumpmanOS/GPOS/OilerOS/MotormanMultipurposeTechnicianOiler/Watchkeeping OSOilerGreaserWiper/GPWiperChief CookCookCook/OSStewardMessmanRatingCadet/TraineeJunior OfficerApprenticeOfficer ApprenticeSM/GPRG/Riding GangCargo EngineerEngine FitterOS EngineNot specified --mwd -- Please select --AFGHANISTANÅLAND ISLANDSALBANIAALGERIAAMERICAN SAMOAANDORRAANGOLAANGUILLAANTARCTICAANTIGUA AND BARBUDAARGENTINAARMENIAARUBAAUSTRALIAAUSTRIAAZERBAIJANBAHAMASBAHRAINBANGLADESHBARBADOSBELARUSBELGIUMBELIZEBENINBERMUDABHUTANBOLIVIA, PLURINATIONAL STATE OFBONAIRE, SINT EUSTATIUS AND SABABOSNIA AND HERZEGOVINABOTSWANABOUVET ISLANDBRAZILBRITISH INDIAN OCEAN TERRITORYBRUNEI DARUSSALAMBULGARIABURKINA FASOBURUNDICAMBODIACAMEROONCANADACAPE VERDECAYMAN ISLANDSCENTRAL AFRICAN REPUBLICCHADCHILECHINACHRISTMAS ISLANDCOCOS (KEELING) ISLANDSCOLOMBIACOMOROSCONGOCONGO, THE DEMOCRATIC REPUBLIC OF THECOOK ISLANDSCOSTA RICACÔTE D'IVOIRECROATIACUBACURAÇAOCYPRUSCZECH REPUBLICDENMARKDJIBOUTIDOMINICADOMINICAN REPUBLICECUADOREGYPTEL SALVADOREQUATORIAL GUINEAERITREAESTONIAETHIOPIAFALKLAND ISLANDS (MALVINAS)FAROE ISLANDSFIJIFINLANDFRANCEFRENCH GUIANAFRENCH POLYNESIAFRENCH SOUTHERN TERRITORIESGABONGAMBIAGEORGIAGERMANYGHANAGIBRALTARGREECEGREENLANDGRENADAGUADELOUPEGUAMGUATEMALAGUERNSEYGUINEAGUINEA-BISSAUGUYANAHAITIHEARD ISLAND AND MCDONALD ISLANDSHOLY SEE (VATICAN CITY STATE)HONDURASHONG KONGHUNGARYICELANDINDIAINDONESIAIRAN, ISLAMIC REPUBLIC OFIRAQIRELANDISLE OF MANIsle of ManISRAELITALYJAMAICAJAPANJERSEYJORDANKAZAKHSTANKENYAKIRIBATIKOREA, DEMOCRATIC PEOPLE'S REPUBLIC OFKOREA, REPUBLIC OFKUWAITKYRGYZSTANLAO PEOPLE'S DEMOCRATIC REPUBLICLATVIALEBANONLESOTHOLIBERIALIBYALIECHTENSTEINLITHUANIALUXEMBOURGMACAOMADEIRA (PORTUGAL)MADAGASCARMADEIRA (PORTUGAL)MALAWIMALAYSIAMALDIVESMALIMALTAMARSHALL ISLANDSMARTINIQUEMAURITANIAMAURITIUSMAYOTTEMEXICOMICRONESIA, FEDERATED STATES OFMOLDOVA, REPUBLIC OFMONACOMONGOLIAMONTENEGROMONTSERRATMOROCCOMOZAMBIQUEMYANMARNAMIBIANAURUNEPALNETHERLANDSNEW CALEDONIANEW ZEALANDNICARAGUANIGERNIGERIANIUENORFOLK ISLANDNORTHERN MARIANA ISLANDSNORWAYOMANOTHERSPAKISTANPALAUPALESTINIAN TERRITORY, OCCUPIEDPANAMAPAPUA NEW GUINEAPARAGUAYPERUPHILIPPINESPITCAIRNPOLANDPORTUGALPUERTO RICOQATARRÉUNIONROMANIARUSSIAN FEDERATIONRWANDASAINT BARTHÉLEMYSAINT HELENA, ASCENSION AND TRISTAN DA CUNHASAINT KITTS AND NEVISSAINT LUCIASAINT MARTIN (FRENCH PART)SAINT PIERRE AND MIQUELONSAINT VINCENTSAMOASAN MARINOSAO TOME AND PRINCIPESAUDI ARABIASENEGALSERBIASEYCHELLESSIERRA LEONESINGAPORESINT MAARTEN (DUTCH PART)SLOVAKIASLOVENIASOLOMON ISLANDSSOMALIASOUTH AFRICASOUTH GEORGIA AND THE SOUTH SANDWICH ISLANDSSOUTH SUDANSPAINSRI LANKASUDANSURINAMESVALBARD AND JAN MAYENSWAZILANDSWEDENSWITZERLANDSYRIAN ARAB REPUBLICTAIWANTAJIKISTANTANZANIA (ZANZIBAR)THAILANDTIMOR-LESTETOGOTOKELAUTONGATRINIDAD AND TOBAGOTUNISIATURKEYTURKMENISTANTURKS AND CAICOS ISLANDSTUVALUUGANDAUKRAINEUNITED ARAB EMIRATESUNITED KINGDOMUNITED STATESUNITED STATES MINOR OUTLYING ISLANDSURUGUAYUZBEKISTANVANUATUVENEZUELA, BOLIVARIAN REPUBLIC OFVIETNAMVIRGIN ISLANDS, BRITISHVIRGIN ISLANDS, U.S.WALLIS AND FUTUNAWESTERN SAHARAYEMENZAMBIAZIMBABWEOTHERS Documents ISM Certificate (PDF)*: Safe Manning (PDF)*: Certificate of Registry (PDF)*: P&I Cover (PDF): Other Document (PDF): I have read and accepted the information on data protection. Register © 2025 ver.di, ITF