Load Line Tonnage ILL-66 ITC-69 Revision & Approval X YES — NO Revision & Approval X YES NO Freeboard Calculation Tonnage Calculation Other Plan/Manual Approval (Specify): Other Calculation (Specify): Certificates & Surveys (Continued)-For each certificate fill the box according to the following letters: I: Initial // A: Annual // In: Intermediate // P: Periodical R: Renewal // Ad: Additional// C: Change of Name, Flag, RO (Specify) // OS: Other Services (Specify): ILO Conventions (Accommodation of Crews & Lifting Appliances) CICA (ILO-68, 92 & 126) Lifting Appliances (Derricks & Cranes) ILO-152 CICA Derricks certification Maximum of crew members according the accommodation arrangements Number of derricks SWL Cranes Certification Number of Cranes SWL Other Certificates Chemical Tankers & Gas Carriers (IBC/IGC Codes) IBC-Code (Chemical Tankers constructed on or Caribbean Code (CCSSC) after 1-July-1986) IGC-Code (Gas Carriers constructed on or MODU-Code after 1-July-1986) Special Purpose Ships High-Speed Craft Bollard Pull Certification Other Certificate (Specify): Note: Copy of existing certificates and supplements attached to the certificates to be submitted to Class ARS -Head Office including pages with Intermediate endorsements Certification Scenarios Re-activation of Statutory Certificates Change of Recognized Organization Change of Flag / Change of Ship´s Name Other Scenario (Specify):
Load Line Tonnage ILL-66 ITC-69 Revision & Approval X YES — NO Revision & Approval X YES NO Freeboard Calculation Tonnage Calculation Other Plan/Manual Approval (Specify): Other Calculation (Specify): Certificates & Surveys (Continued)-For each certificate fill the box according to the following letters: I: Initial // A: Annual // In: Intermediate // P: Periodical R: Renewal // Ad: Additional// C: Change of Name, Flag, RO (Specify) // OS: Other Services (Specify): ILO Conventions (Accommodation of Crews & Lifting Appliances) CICA (ILO-68, 92 & 126) Lifting Appliances (Derricks & Cranes) ILO-152 CICA Derricks certification Maximum of crew members according the accommodation arrangements Number of derricks SWL Cranes Certification Number of Cranes SWL Other Certificates Chemical Tankers & Gas Carriers (IBC/IGC Codes) Caribbean Code (CCSSC) IBC-Code (Chemical Tankers constructed on or after 1-July-1986) MODU-Code IGC-Code (Gas Carriers constructed on or after 1-July-1986) Special Purpose Ships High-Speed Craft Bollard Pull Certification Other Certificate (Specify): Note: Copy of existing certificates and supplements attached to the certificates to be submitted to Class ARS -Head Office including pages with Intermediate endorsements Certification Scenarios Change of Recognized Organization Re-activation of Statutory Certificates Change of Flag / Change of Ship´s Name Other Scenario (Specify):
QP-3.1-1%20Form%2001-Class%20ARS%20Application%20for%20Statutory%20Certificates.docx