This report is the National Regulator’s preferred method for surveyors to record the principal particulars of a Domestic Commercial Vessel. It is not required to be submitted where an accredited surveyor has entered these details directly into the AMSA survey portal MARS.

Vessel details

Vessel name:	Vessel Type

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Name of surveyor:	Surveyor identification number:
Measured length (m):	Length Overall (m):
Loadline length (m):	Breadth (m):
Max design speed (kts):	Hull Material:
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Design displacement (t):	Gross tonnage (t):
Hull primary colour:	Secondary colour:

Displayed vessel number:	Hull number:

Call sign:	MMSI:

Accommodation level:	KWP of largest engine:

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Number of fuel tanks:	Fuel Type:

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Drive type:	Number of shafts:
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Flooding risk category:	Fire risk rating:
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SFP Rating (highest):	Standard hull structure is designed to:
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AC voltage:	DC Voltage:
Standard(s) vessel is built to:
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Service category and person numbers plan approval was conducted for

Service Category:	Crew:	Unberthed Pax:	Berthed Pax:	Special persons:

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Operational details

Tick applicable operations:

Dangerous goods	☐	Net reel or installed deck load	☐	Towing	☐
Offshore oil and gas	☐	Overnight operations	☐	Fast Craft	☐
Constrained by draft	☐	Restricted in ability to manoeuvre	☐	Transfers at sea	☐
Diving	☐	Dredging	☐	Fishing	☐
Lifting	☐	Pilotage	☐	Sailing	☐
Trawling	☐	Close proximity purse seining	☐	Close proximity trawling	☐

Anchor details

No:	Weight (kg):	Type:	Chain Size (mm):	Chain Length (m):	Rope size (mm):	Rope length (m):

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Engine details

Make:	Model:	KWP:	Engine Description:

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Gearbox details

Make:	Ratio:

Aux machinery

Make:	Number:	Description:

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Engineering equipment

Number of seawater valves:	Number of compressors:

Number of bilge pumps:	Number of refrigerated compartments:

Refrigerated compartment details:

Deck penetrations

Number of access openings in bulkheads:	Number of tarpaulins:

Number of hatches:	Number of machinery & miscellaneous openings:

Number of ventilators: Vessel builder	Number of air pipes:
Number of cargo ports (or similar):	Number of freeing ports / scuppers:
Number of inlets and discharges (skinfittings):	Number of side scuttles:

Notes

Surveyor’s declaration

I declare that:

I consent to the Australian Maritime Safety Authority using and disclosing the information provided in this form for purposes associated with the administration of the Marine Safety (Domestic Commercial Vessel) National Law Act 2012.

I understand and acknowledge that the Australian Maritime Safety Authority, as the National Regulator, may ask that I provide any information or document that the National Regulator reasonably considers necessary in relation to this submission.

Signature of surveyor	Date