Name of ship; Distinctive number or letters;
Port of registry; Gross tonnage; Sea areas in which ship is certified to operate; IMO number; Date on which keel was laid. Certifying statement that the ship has been surveyed in accordance with SOLAS and that the survey showed the ship complied with SOLAS requirements as regards: structure, main and auxiliary machinery, boilers and other pressure vessels; watertight subdivision arrangements and details; subdivision load lines (detailed on the certificate); structural fire protection, fire safety systems and appliances and fire control plans; life-saving appliances and equipment of lifeboats, liferafts and rescue boats; line-throwing appliance; radio installations used in life-saving appliances; radio installations; functioning of radio installations used in life-saving appliances; shipborne navigational equipment, means of embarkation for pilots and nautical publications; lights, shapes, means of making sound signals and distress signals; and all other respects. Note of any Exemption Certificate issued. Expiry date. Place and date of issue. Surveyor’s signature and name, MCA stamp. There is space below for any extension granted.