These pages contain an index of Forms which relate to the functions of the Australian Maritime Safety Authority. To access Forms, simply click on the desired format and follow the instructions given.
Note: the majority of these Forms have been created in Adobe Acrobat. 
Marine Environment Protection
| Title | Format | Form Number | Current version |
|---|---|---|---|
| Automated Data Inquiry for Oil Spills (ADIOS) Weathering Model | html | ||
| Automated Data Inquiry for Oil Spills (ADIOS) Weathering Model - Update or Amend ADIOS Oil Properties Pro Forma | html | ||
| Application for Certificate of Insurance - Civil Liability Convention (oil tankers) | PDF: 175Kb |
AMSA 350 CLC | 4/08 |
| Application for Certificate of Insurance - Bunkers Convention (vessels other than oil tankers >1000 gt) | PDF: 175Kb |
AMSA 350 B | 4/08 |
| Declaration on Anti-Fouling System | AMSA 239 | 10/07 |
|
| Format for Reporting Alleged Inadequacies of Port Reception Facilities | html | ||
| Local Fuel Suppliers Initial Declaration |  DOC: 59Kb |
AMSA 235 | 9/07 |
| Oil Spill Trajectory Model (OSTM) Request Proforma | html | ||
| Standard Format for Standard Letter of Undertaking for Financial Security | html |
Navigation
| Title | Format | Form Number | Current version |
|---|---|---|---|
| Application for an Australian Non-shipborne AIS licence | AMSA 234 | 9/07 |
|
| DGPS Service Feedback form | html |
Search and Rescue
| Title | Format | Form Number | Current version |
|---|---|---|---|
| Aerorescue Data Media Package and Handling Record | AMSA 61 | 4/06 |
|
| Australian Search and Rescue Award Nomination | PDF: 10Kb |
AMSA 124 | 5/01 |
| Australian Maritime Mobile Service Identity (MMSI) Registration | AMSA 89 | 12/07 |
|
| Beacon Registration Form | PDF: 313Kb DOC: 197Kb |
AMSA 6 | 12/07 |
| Beacon Disposal Form | AMSA 245 | 8/07 |
|
| Flare Demonstration Notification Form | PDF: 51Kb |
AMSA 50 | 3/05 |
| Flight Note | PDF: 68Kb |
AMSA 104 | 11/05 |
| Supplementary Search and Rescue Unit Application | PDF: 176Kb |
AMSA 134 | 7/04 |
Marine Qualifications
| Title | Format | Form Number | Current version |
|---|---|---|---|
| Application for a certificate and/or endorsement | PDF: 253Kb |
AMSA63 | 10/07 |
| Application for revalidation/replacement of a certificate or endorsement | PDF: 120Kb |
AMSA107 | 7/07 |
| Application for licence as compass adjuster | PDF: 122Kb |
AMSA409 | 8/04 |
| Certificate of Medical Fitness | PDF: 16Kb |
AMSA303 | 11/03 |
| Coastal Pilot - Application for licence/renewal | AMSA1021 | 3/08 |
|
| Marine Qualifications Credit Card Payment Authority | PDF: 136Kb |
AMSA161 | 1/07 |
| Medical Examination Request | PDF: 120Kb |
AMSA302 | 2/03 |
| Medical Examination Report | PDF: 158Kb |
AMSA232 | 11/03 |
| Seafarer's application for assessment of overseas qualifications for the purpose of a migration application | PDF: 76Kb |
AMSA12 | 5/08 |
| Guides to calculation of sea time (for further information see Eligibility Requirements) |
DOC: 69KbShip Operations
| Title | Format | Form Number | Current version |
|---|---|---|---|
| Application for survey of ship or ship's equipment | PDF: 80Kb |
AMSA 41 (MO 31/1) |
8/04 |
| Articles of Agreement and List of Crew | Available from AMSA Offices | AMSA 290 | 5/04 |
| Notice of alteration or damage to an Australian ship (MO 91 - Marine Pollution Prevention - Oil) | PDF: 68Kb |
AMSA 192 (MO 91/1) |
4/05 |
| Notice of alteration or damage to an Australian ship (MO 93 - Marine Pollution Prevention - Noxious Liquid Substances) | PDF: 71Kb |
AMSA 193 (MO 93/1) |
4/05 |
| Notice of alteration or damage to an Australian ship (MO 97 - Marine Pollution Prevention - Air Pollution) | PDF: 71Kb |
AMSA 253 (MO 97/1) |
5/08 |
| Notice of alteration or damage to an Australian ship (MO 98 - Anti-fouling Systems) | PDF: 71Kb |
AMSA 254 (MO 98/1) |
5/08 |
| Harmful substances report (POLREP) (MO 91 - Marine Pollution Prevention - Oil) | PDF: 75Kb |
AMSA 197 (MO 91/2) |
4/05 |
| Harmful substances report (POLREP) (MO 93 - Marine Pollution Prevention - Noxious Liquid Substances) | PDF: 75Kb |
AMSA 196 (MO 93/2) |
4/05 |
| Table of deviations of the standard/steering compass | PDF: 127Kb |
AMSA408 | 8/04 |
| Compass deviation record | PDF: 89Kb |
AMSA 410 | 9/02 |
| Multimodal Dangerous Goods Form | AMSA250 | 11/03 |
|
| Incident alert | PDF: 58Kb DOC: 150Kb |
AMSA18 | 1/08 |
Incident report |
PDF: 78Kb DOC: 174Kb |
AMSA 19 | 2/08 |
| Application for an Australian certificate for the carriage of livestock | AMSA338 | 1/07 |
|
| Notice of intention to load livestock | PDF: 67Kb DOC: 67Kb |
AMSA32 | 9/02 |
| Masters report carriage of livestock | AMSA337 | 1/07 |
|
| Summary of radio survey/inspection | PDF: 89Kb |
AMSA219 | 1/03 |
| Radiocommunications equipment survey details | PDF: 115Kb |
AMSA220 | 1/03 |
| Report of suspected non-compliance with Navigation Act or safety/pollution conventions | AMSA355 (SV-HH) |
7/04 |
|
| Loading, or sailing after partial discharge, of bulk grain | PDF: 304Kb DOC: 541Kb |
AMSA225 (MO33) | 6/05 |
| Shipper's Declaration (MO 34, MO 42) | AMSA 268 | 1/07 |
|
| Register of Materials Handling Equipment | PDF: 124Kb |
AMSA 357 | 1/98 |
| Oil Record Book - Part 1 | Available from AMSA Offices | AMSA 228 | 9/06 |
| Oil Record Book - Part 2 | Available from AMSA Offices | AMSA 229 | 9/06 |
| Cargo Record Book | Available from AMSA Offices | AMSA 227 | 9/06 |
| Garbage Record Book | Available from AMSA Offices | AMSA 230 | 9/06 |
| Application form - Section 8A (Declared vessel) | PDF: 32Kb |
||
| Application form - Section 8AA (Declared vessel) | PDF: 32Kb |
Shipping Registration
If you cannot access these forms or any of the publications on our website, please email the Public Relations or ring 02 6279 5820.
last updated: April 2008