Proposed Name of Yacht.
Preferred Name choice and alternative Name(s).
Alternative Name(s).
If a new construction:
Builder's name and Address.
Yard/hull Number.
Current Name.
IMO Number.
Current Flag.
Proposed Date and Place of Purchase or delivery.
Proposed date of registration under Belize Flag.
Port/place where yacht will be at time of registration.
By whom will the yacht be surveyed on behalf of IMMARBE? Name of Classification Society/Recognized Organization or authorized surveyor or other Administration.
Name of Owner(s) or prospective owner(s)
IMO Unique Registered Owner Identification Number (mandatory for Super Yachts/500GT or more)
Name of Bareboat Charterer(s) (if applicable)
Name of Manager or Prospective Manager (ISM Code is mandatory for Super Yachts in commercial use /500Gt or more)
Company IMO Unique Identification Number (ISM Code is mandatory for Super Yachts in commercial use /500Gt or more)
Other material information (e.g. arrest, auction, etc)
PARTICULARS OF YACHT
Type of Vessel
Year Built
Built by
Built at
Year Converted
Converted at
Converted by
Conversion approved by
Load Line Length in metres
Breadth in metres
Moulded Depth in metres
Height in metres
Gross Tonnage
Net Tonnage
Material of Hull
Number of Hulls
Number of Masts
Number of Decks
Service Speed
PARTICULARS OF PROPELLING ENGINES
How Propelled
Number & type of Engines
Power (choose one) BPM/Kw
Date built(engine)
Name of Engine Manufacturer
PARTICULARS OF RADIO EQUIPMENT
State if Fitted yes/no
Primary Systems
VHF Radio Installation
DSC Encoder
DSC Watch receiver
Radiotelephony
MF/HF Radio installation
Direct-printing radiotelegraphy
INMARSAT ship earth station
Secondary means of alerting
Facilities for reception of Maritime safety information
NAVTEX receiver
EGC receiver
HF direct printing radio‐telegraph receiver
Satelitte EPIRB
COSPAS-SARSAT
INMARSAT
VHF EPIRB
Ship's radar Transponder
GPS
AIS
SSAS (INMARSAT mini-c or D+ or HF telex system identification no.)
PARTICULARS OF USE
Commercial/Private
Operation: Miles from Safe Haven: up to 20/30/60/100/150/unlimted miles
CORRESPONDENCE
This information will be used for safety alerts (EPIRB) and invoicing such as annual fees. Failure to advise changes to this information may possibly result in delays in responding to safety/security alerts, vessel delays, delays in document processing. The owner/manager is requested to notify IMMARBE immediately of any changes.
Contact Person & Street Address for General Correspondence after registration
Your Name
Email
Phone
Street Address
City
Facsimile
24 hour Emergency contact for safety alerts (mandatory)
MORTGAGE DATA
Will a mortgage be registered after registration of yacht?
Is there an existing registered mortgage?
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