Division

Service time on board, name of craft: …

Unique European vessel identification number or other official craft number: …

Type of craft …

State of registration: …

Length of craft in m*, /number of passengers* …

Owner (name and address): …

…

Holder assumed service as: …

Holder assumed service on (date): …

End of service (date): …

Boatmaster (name and address): …

Date, place and signature of boatmaster: …