CG5585 Application

The following information is necessary for us to commence the CG5585 application process.

Please take a few minutes to complete the requested information. We must also have a valid Letter of Authority in order to complete the application on Owner's behalf. Click on the Send to SIGCo button when completed and your request will automatically be e-mailed to us.

If you would prefer to fill out this form manually, please click here to download a hard copy.

Note: All fields marked with a star * are required.

Your Name:	*
Your E-Mail Address:	*
COFR Request is:	*	Please Select.................................................... New Addition Renewal
Name of Insurance Broker:
Name of company:			If not Insurance Broker.
Return Fax No:	*
Return Email Address:
Vessel name:	*		And ex-name, if known.
Flag:	*		Please type in full.
Vessel Type	*	Please Select..................................................................................... Breakbulk Freighter Containership Roll on-Roll off (Car carriers / vehicle) Barge Carrier (lash, seabee) Comb. breakbulk/containership Comb. roll on-roll off containership Comb. barge carrier containership Tanker (lpg / chemical tanker / suezmax) Dry bulk Carrier (Woodchip/Multi Purpose /Panamax) Other Self-propelled cargo (Reefer/General Cargo/Gearless) Oil/bulk/Ore Carrier Passenger Vessel Comb. Passenger/cargo Ferry All pleasure craft Tank barge Tug & Towboat Barge & Scow (Pontoon) Mobile offshore drilling unit Fishing Vessel Factory Vessel Research Vessel All other utility craft Vessels not otherwise specified (cement / training vessels)
Gross Tonnage:	*
Year Built:	*
Owner same as Operator:	*	Please Select................................................... Yes No	Select 'Yes' if the owner name is the same as the operator name.
IMO Number:	*
Name of operator / applicant:	*
Applicant's address:	*
Applicant's Phone No:	*
Applicant's Fax No:	*
Applicant's Email Address:	*
Applicant's place of incorporation:	*
Applicant's date of incorporation:	*
Type of company:	*		Limited Liability, Partnership, etc.
Owner's Name:	*
Owner's address:	*
Certificate Address:	*		The certificate will be sent to the applicant address unless otherwise advised. Please advise here if the certificate is to be sent to an alternate address. IMPORTANT: Certificates can not be delivered via courier to a P.O. Box.
Please also provide the following if applicable:
Existing control number:
Expiry date of existing COFR:			Format: dd/mm/yy
Please type the characters you see into the box below.
Verification Code:
You will receive an email notification after your request is received by SIGCo.