Preliminary Registration Application Form

What are you interested in? Please check the appropriate boxes:

            Registration of a Ship's ownership title

            Registration of Ship's mortgage

            Registration of Ship's mortgage cancellation

            Other:

Please let us know about your organization:

                            Your name:

                            Title:

                            Your Company:

                            Address:

                            Telephone:

                            Fax:

                            E-Mail:

VESSEL IDENTIFICATION

            Name of the Ship:   

            Former name:   

             Radio Call Letters:   

            Certificate of Registry:           

                                          If registered in Panama, please indicate:

            TOMO (Volume):  FOLIO (Page):  ASIENTO (entry):

            Vessel description:

            Gross Tonnage:         Net Tonnage:

            Length:           Breadth:             Depth:

            Value:

            Year of construction:

            Legal representatives in Panama:

            Class society:

PRELIMINARY REGISTRATION OF OWNERSHIP TITLE

            Transferor of ownership (Seller, indicate if it is the builder):                 

            Domicile:

            If a corporation, registered in:

                                           If a Panamanian corporation, please indicate: 

            TOMO (Volume):  FOLIO (Page):  ASIENTO (entry):

            ROLLO (roll): IMAGEN (Image): FICHA (Filing Card):

            Name of the Representative in this act:

            Domicile:

            Relationship with the entity represented (if a proxy, indicate whether general or special proxy):

            Purchaser of ownership (Buyer):

            Domicile:

PRELIMINARY REGISTRATION OF SHIP'S MORTGAGE

            Mortgagee:

            Domicile:

            If a corporation, registered in:

                                            If a Panamanian corporation, please specify: 

            TOMO (Volume):  FOLIO (Page):  ASIENTO (entry):

            ROLLO (roll): IMAGEN (Image): FICHA (Filing Card):

            Name of the Representative in this act:

            Domicile:

            Relationship with the entity represented (if a proxy, indicate whether general or special proxy):

            Amount of mortgage:

            Time Period:

            > THE MORTGAGEE DECLARES that he agrees to the Ship's transfer, keeping the mortgage registration, 

                                                     > please type YES or NO:  

            > THE MORTGAGEE DECLARES his willingness to have the aforementioned mortgage cancelled, 

                                                     > please type YES or NO:  

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