Australian Maritime Safety Authority

Forms

If you have trouble accessing any of these forms, please contact AMSA Communication.

Marine Environment Protection

Title Format Form Number Current
version
Application for Certificate of Insurance - Civil Liability Convention (oil tankers)

Microsoft Word Icon DOC: 50Kb
PDF Icon PDF: 175Kb

AMSA 350 CLC 10/13
Application for Certificate of Insurance - Bunkers Convention
(vessels other than oil tankers >1000 gt)

Microsoft Word Icon DOC: 50Kb
PDF Icon PDF: 175Kb

AMSA 350 B 2/17
Declaration on Anti-Fouling System

Microsoft Word Icon DOC: 50Kb
PDF Icon PDF: 130Kb

AMSA 239 10/07
Format for Reporting Alleged Inadequacies of Port Reception Facilities PDF Icon PDF: 175Kb
Local Fuel Oil Suppliers Declaration Microsoft Word Icon DOC: 59Kb AMSA 235 10/17
Waste Delivery to Port Reception Facilities - Advance Notification Microsoft Word Icon DOC: 180Kb AMSA 261 3/11
Waste Delivery Receipt Microsoft Word Icon DOC: 112Kb AMSA 262 11/08
National Plan Spill Trajectory Modelling Request Microsoft Word Icon DOC: 79Kb AMSA 95 07/15
Bunker Delivery Note

Microsoft Word Icon DOC: 50Kb
PDF Icon PDF: 130Kb

AMSA238 01/14

If you cannot access these forms please email AMSA Communication or ring 02 6279 5820.

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