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AMSA 350 CLC

Application for certificate of insurance – civil liability convention (oil tankers)

Overview 

You can use this form to apply for a Certificate of insurance  civil liability convention (oil tankers).

How to complete this form 

  • Ensure that the application form and the P&I Club Blue Card accurately reflect the ownership details of the vessel (for Australian vessels, as per details held in the Australian register of ships).
  • Charter details as well as ownership details should be listed on both the application and the blue card.
  • Ensure that details on the application form are consistent with the blue card ie address details, ports of registry etc.
  • A fee of A$70 is payable for the issue of a first certificate or, in the case of certificate renewal, when substantial changes are made.
  • A fee of A$40 is payable on annual renewal of the certificate where existing insurance arrangements continue, or are not substantially changed.
  • Please complete the application form using the explanatory notes on the right hand side of each page.

Submitting the form 

You can submit your enquiries and completed applications to:

Manager
Ship Inspection and Registration
Australian Maritime Safety Authority
82 Northbourne Avenue, Braddon, ACT
GPO Box 2181 Canberra City 2601
Ph (02) 6279 5040
Fax (02) 6279 5026
Email opsSIRAdmin@amsa.gov.au

Last Updated: 

14 September 2018