Reinstatement of Documentation

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NOTE: FILING THIS APPLICATION DOES NOT ENTITLE A VESSEL TO DOCUMENTATION OR TO ANY CHANGES SOUGHT 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) HAS PASSED 30 DAYS OF EXPIRATION, YOU MUST REINSTATE YOUR DOCUMENTATION.
A.Vessel Name (Required)*
B. OFFICIAL NUMBER*
CONFIRM OFFICIAL NUMBER*
C. HULL ID # (IF ANY)

Insert Hull Identification Number (HIN) as assigned in accordance with 33 CFR 81.
D. IMO # (IF ANY)

Insert International Maritime Organization Number (IMO), if any.
E. HAILING PORT INCLUDING STATE

Insert the name of city and state exactly as it is marked on the vessel.
Name, e-mail address, and telephone number of the owner to whom the Coast Guard should send correspondence and their Social Security Number (SSN) or Tax Identification Number (TIN). Only an owner or co-owner can be the managing owner. For vessels owned by a corporation, the corporation is the managing owner. For a trust arrangement, the trust is the managing owner. For a Partnership or an LLC, the name of the Partnership or the LLC is the owner.
NAME OF MANAGING OWNER

IMPORTANT: ALL registered owners must be included. Please enter any additional owners in section H below.
Contact Email*
Enter Email Confirm Email
Contact Telephone Number*
(###) ###-####
SOCIAL SECURITY OR TAX ID NUMBER (46 USC 12104): (SECURE FORM)
IS THIS NUMBER YOUR SOCIAL SECURITY NUMBER OR YOUR TAX ID NUMBER?
- SOCIAL SECURITY NUMBER
- TAX ID NUMBER
F. PHYSICAL ADDRESS OF MANAGING OWNER (REQUIRED – 46 CFR 67.113)
Street Address City State ZIP Code
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
G. Are there any additional owners recorded with the vessel and listed on the Certificate of Documentation?
If no, leave as is, otherwise select yes below and include all additional owners recorded with the vessel and listed on the Certificate of Documentation.

Additional Owners

Name / Entity	Social Security Number (Individual)	Tax ID Number (Business Entity)	Actions

There are no Additional Owners.

VESSEL NAME WHEN LAST DOCUMENTED:
VESSEL
- WAS BUILT AT
- IS UNDER CONSTRUCTION AT
AT

City, State, Country
IN

Month, Year
IS UNDER CONSTRUCTION AT
AND IS SCHEDULED FOR COMPLETION IN
HULL MATERIAL:
- WOOD
- STEEL
- FIBROUS REINFORCED PLASTIC
- ALUMINUM
- CONCRETE
- OTHER
DESCRIBE
OVERALL VESSEL DIMENSIONS:
Overall Length (L)
Overall Breadth (B)
Overall Depth (D)
Gross Weight (Tons)
Net Weight (Tons)
PREVIOUS NAMES, NUMBERS, OR FOREIGN REGISTRATIONS OF VESSEL
H. ENDORSEMENTS FOR WHICH APPLICATION IS MADE
Check the appropriate block(s) to indicate all endorsement(s) sought on this application.
- 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)
I. PRIMARY SERVICE & HORSEPOWER: SELECT ONLY ONE SERVICE FOR WHICH THE VESSEL WILL BE PRIMARILY USED AND INSERT HORSEPOWER
- COMMERCIAL FISHING BOAT
- FISH PROCESSING VESSEL
- FREIGHT SHIP
- FREIGHT BARGE
- INDUSTRIAL VESSEL
- MOBILE OFFSHORE DRILLING UNIT
- OIL RECOVERY
- OFFSHORE SUPPLY VESSEL
- PASSENGER (6 OR FEWER)
- PASSENGER (MORE THAN 6)
- PASSENGER BARGE (6 OR FEWER)
- PASSENGER BARGE (MORE THAN 6)
- PUBLIC FREIGHT
- PUBLIC TANKSHIP/BARGE
- PUBLIC VESSEL, UNC
- RECREATIONAL
- RESEARCH VESSEL
- SCHOOL SHIP
- TANK BARGE
- TANK SHIP
- TOWING VESSEL
- UNCLASSIFIED VESSEL
HORSEPOWER

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PRIORITY REQUEST REQUEST / RUSH PROCESSING

PREFERRED MORTGAGE

SATISFACTION OF MORTGAGE