Vessel Application Forms
The following combined registration publications are available for viewing in Microsoft Word (online editing) and Adobe PDF formats.

Completed registration packages may then be faxed or mailed to your Regional Sales Office or to the main office in the U.S. listed above.

Vessel Registration Forms

The following file available for download includes all of the required vessel registration applications and forms, as well as Sample forms for providing supporting documentation.

Vessel Registration Forms - Combined Publication (PDF) (revised 04/07)

Vessel Registration Forms - Combined Publication (MS Word) (revised 04/07)

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Mariner Application Forms
The following file available for download includes all of the required mariner licensing applications and forms.

Mariner Certification Application Forms - Combined Publication (MS Word) (revised 09/06)

Mariner Certification Application Forms - Combined Publication (Adobe PDF) (revised 09/06)

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Individual Forms
Below are individual applications and reporting forms, all provided in Word Format. If you are looking for the complete Vessel Registration Forms Package or the Mariner Application Forms Package, go back to Forms page and choose one of those options.

Vessel Registration Forms
Application for Official Number, Call Sign and Registration of a Vessel

Application for Official Number, Call Sign and Registration of a Yacht

Application for Official Number, Call Sign and Registration for Bareboat Charter

Application for Official Number, Call Sign and Provisional Certificate of Intended Registration of New Building, During Construction at Builder’s Yard

Affirmation of Officer of an Incorporated Company as Prospective Owner of a Newbuild During Construction at Builder’s Yard and Intended for Commonwealth of Dominica

Application for Registration as a Foreign Maritime Entity Under the Commonwealth of Dominica International Ship Registry Act

Application for Dominica International Business Company

Application for Ship’s Radio License

Application for Minimum Safe Manning Certificate

Power of Attorney or Corporate Resolution Authorizing Person(s) to Register the Vessel.

Declaration by A Pleasure Yacht Owner

Request for Waiver of Age

Continuous Synopsis Record Application
CDVR-2023 Continuous Synopsis Record Application

ISPS Forms
CSO Statement of Compliance

Report of Inadequate Port Reception Facility

ISM Forms
ISM – Declaration of “Company”

ISM – Declaration of “Designated Person(s)”

Monthly Reports to Dominica
Crew List Report

Crew Change Monthly Reports

Route Planning Monthly Report

Mortgage Forms
Memorandum of Particulars

Form for Release of Mortgage

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Vessel Log Book and Manual Forms
Below are links to downloadable templates for multiple Manuals and Logbooks vessels may be required to carry onboard.

Crew Articles of Agreement/Shipping Articles

Official Log Book

GMDSS Radio Log Book

Oil Record Book (currently being updated)

Cargo Record Book

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Reporting Forms
Below are links to various forms for submitting required information from the Vessel to the Flag State Administration. These can also be found separately under our Marine Safety Circulars page on this website (http://www.dominica-registry.com/index.php?option=content&task=category&sectionid=1&id=10&Itemid=58)

CD-MSC 07-01
Reporting Incidents of Piracy and Armed Attacks

CD-MSC 39-01
Reporting Certificate Fraud and Professional and Technical Incompetence

CD-MSC 10-03
Inadequate Port Reception Facility Report

CD-MSC 11-03
Report of Ship’s Officers and Repatriation

CD-MSC 13-03
Casualty Incident and Accident Investigations

CD-MSC 13-04 rev att.CDVR-2026
Crew changes reporting

CD-MSC 14-04 rev att.CDVR-2027
Route planning reporting program

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Continuous Synopsis Record (CSR) Forms
Below are links to guidance documents and applications for Continuous Synopsis Records.

Continuous Synopsis Record - format and guidelines for the maintenance (CD-MSC 01-04rev.2)

Continuous Synopsis Record Application Form

Continuous Synopsis Record Amendment Form

CSR - Index of Amendments Form

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ISPS Forms
Below are links to the multiple guidance documents and application forms for vessels which fall under the ISPS (International Ship and Port Security Code):

Guidance for Development of Ship Security Plan (SSP)

Ship Security Plan Template

Ship Security Plan Checklist

Marine Safety Circular Guidance for SSP Approval & International Ship Security Certificate Issuance

Marine Safety Circular ISPS Code Interim Certification

Company Security Officer's Statement of Ship's Compliance (MS Word)

IMO Additional Guidance for ISPS compliance

Marine Safety Circular Combined Procedures for SSP Approval & ISPS Code verification and certification

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