General Yacht Information Form Name of Vessel: * Type of Vessel: M/YM/VM/TS/YCatamaranShoonerOther As you have chosen other, please input your vessel type. Voyage No IMO Number * Master's Name INBOUND * Gross Tonnage * Net Tonnage * Flag Port of Registry Country of Registry Call Sign DWT Not Required for yachts! Inbound Draft Forward (FEET) Inbound Draft Aft (FEET) No of crew inbound No of Passengers Do you have any of the following aboard Mail Cargo Arms Ammunition Passengers Animals Stowaways Vessel's Registration No LOA (METERS) Beam (METERS) Cruising Speed How many engines Information about engine type: Cruising Radius How far can you travel on a full tank of fuel at cruising speed? No of Ratings How many licensed officers are aboard for the bridge area only? ISSC Number Not applicable to yachts under 500 GRT. Date ISSC Issued Not applicable for vessels under 500 GRT ISSC Expiration Date Not applicable for vessels under 500 GRT Current Security Level Last Port of Call Next Port of Call Last 10 Ports of Call Last 10 ports of call prior to arriving in Belize. ETA Pilot Station ETD VHF Working Frequency Email Address * Contact Number * Owners Name Owners Address 1 Owners Address 2 Owners Address 3 Vessel's Operator P & I Club P & I Club Address and Contact No Hull & Machinery Insurers Hull & Machinery Insurers Address and Contact No Hull Material FiberglassMetalAluminiumWoodOther You selected other for hull material. Please input hull material here. Vessel's Registration Drop a file here or click to upload Choose File Maximum file size: 516MB Crew List Drop a file here or click to upload Choose File Maximum file size: 516MB Passenger List Drop a file here or click to upload Choose File Maximum file size: 516MB Captain's Certificate No Captain's License number Paragraph Captain's Certificate Type For example Master 3000 GRT Captains License Issued Country of Issue Captain's License Expiry Date Is the Captain fluent in English Yes No Captain's previous experience in Belizean waters. Name of First Officer First Officer's Certificate No First Officer's License number First Officer's Certificate Type For example Master 3000 GRT First Officer License Issued at Country of Issue First Officer's License Expiry Date Is the First Officer fluent in English Yes No First Officer's previous experience in Belizean waters. Name of Second Officer Second Officer's Certificate No Second Officer's License number Second Officer's Certificate Type For example Master 3000 GRT Second Officer's License Issued at Country of Issue Second Officer's License Expiry Date Is the Second Officer fluent in English Yes No Other Officer's previous experience in Belizean waters. ISSC Certificate Drop a file here or click to upload Choose File Maximum file size: 516MB Not required for vessel's under 500 GRT Upload copy of vessel's International Ships Security Certificate P & I Certificate Drop a file here or click to upload Choose File Maximum file size: 516MB Upload a copy of vessel's P & I Certificate Continuous Synopsis Record Drop a file here or click to upload Choose File Maximum file size: 516MB Not required for vessels under 500 GRT Please upload a copy of vessel's CSR (Continuous Synopsis Record) Record of Tenders, Jet Skis and other Appurtenances Drop a file here or click to upload Choose File Maximum file size: 516MB Tender Manifest Submit the General Yacht Information Form.