Registrar of Ships

Take notice that 1

of 2

claiming the interest described below in 3

the ofﬁcial number of which ship is

forbids the entry in the Register of any instrument relating to any dealing with the said ship or share.

The interest claimed in the said ship or share is 4

The address at which notice relating to this caveat or to which proceedings in
respect of this caveat may be served is 5

Dated at

on the day of 20

Signed by 6

7

8

9................................................................................................................................................

in the presence of 10

11 …………………………………………………………………………………………………………………….…..

1 Full name of caveator in block letters

2 Address of caveator in block letters

3 Description sufﬁcient to identify the ship and, where appropriate, the share in the ship in which the caveator claims the interest

4 Description sufﬁcient to identify interest claimed by caveator

5 Specify address within Australia

6 Full name of caveator solicitor or agent

7 If signed by solicitor or agent, statement to that effect

8 Ofﬁce address of solicitor or residential address of agent

9 Signature

10 Legible statement of name and address of witness

11 Signature

Except where indicated by * the collection of information requested in this form is either required or authorised by the Shipping Registration Act 1981 (the Act). It will be used for purposes related to the Act (including possible overseas disclosure) and will be available for public search in circumstances as the Act requires. It may be made available to government agencies for statistical and administrative purposes. Failure to provide the information will result in the transaction not being processed. To contact us, or for more information on how to access or correct your personal information or how to make a privacy complaint, visit www.amsa.gov.au/privacy-policy