Get UK MSF 5100 2023

MSF 5100 / REV 1121 APPLICATION FOR SURVEY AND INSPECTION OF SHIPS AND FISHING VESSELS For Guidance Notes see overleaf. UK Pay credit/debit Card Payment BACS/CHAPS Rolling Account orthe Survey Inspection National Business Unit Covering Aberdeen / Belfast / Cardiff / Colchester / Glasgow / Hull/ Liverpool / Plymouth / Southampton / Stability Unit To make payment by Credit/Debit Card CLICK HERE If paying by BACS/CHAPS Sort Code 60-70-80 Account No 10013431 Bank Name NATWEST Account MCA EASTERN IBAN GB02NWBK60708010013431 Swift NWBKGB2L Contact details S I National Business Unit Crosskill House Mill Lane Beverley East Yorkshire HU17 9JB Email S INationalBU mcga.gov.uk 3/4 HEALTH AND SAFETY STANDARDS General In signing the Application for Survey MSF 5100 the owner/manager agrees to provide appropriate safety precautions including those described below. Complete form using BLOCK CAPITALS 1. APPLICANT DETAILS Name Company Address Post code Country Telephone Fax E mail NAME AND ADDRESS OF OWNER/OPERATOR IF DIFFERENT FROM ABOVE 2. PARTICULARS OF SURVEY / INSPECTION APPLIED FOR Ship Name Ship Type Official No IMO No Fishing No Year of build Name of contact Requested date and time of survey / 00 00 24h Where ship can be seen Nature of Survey / Inspection I apply for the survey / Inspection described above and enclose a deposit and agree to pay any additional fees. Our Customer Order Number is if appropriate I am aware that the ship should be prepared ready for survey and appropriate safety precautions taken for all areas to be surveyed including provision of safe means of access for boarding as outlined in the attached Health safety Standards. I understand that Surveyors may refuse to continue with surveys is it is not safe for them to do so and may consider charging for any time wasted* Position in Signature Date PLEASE COMPLETE THE PAYMENT DETAILS SECTION OVERLEAF ON PAGE 3 An Executive Agency of the Department for Transport 1/4 OFFICIAL USE ONLY The Sum of Has been Received Initials Cheque drawn against account of Customer ID Main Project No Sub Project No Works Order No Receipt No Record Deposit Initials 2/4 GUIDANCE NOTES 1. When you have completed this form please send by it by email email is our preferred method of delivery or post to the Marine Office with the appropriate deposit / fee. You can get information on the level of fees from your local Marine Office. Additional charges will be levied for overtime surveys abroad waiting time and abortive time. 2. Credit/Debit Card payment via GOV. UK Pay online payment facility is our preferred payment method. You may also pay using BACS transfer quoting the vessel name as payment reference. If you pay using cheque or postal order it must be made payable to the Maritime Coastguard Agency. Cheques must be paid in sterling. 3. Any refunds or requests for additional fees will be made to the applicant in whose name the account will be held. 4. Work will not start until this form has been completed signed and the deposit / fee received 5. The Maritime and Coastguard Agency MCA will use your contact details to send you information about the service s you are applying for as part of its functions as a government department.