Load Line Exemption Application Form
Applicant Details
Name/Company
Address
Contact Number
Email
Vessel Details
Vessel Name
IMO Number
Flag
Type of Vessel
Gross Tonnage
Net Tonnage
Port of Registry
Exemption Details
Period of Exemption Requested
Voyage(s) Details
Reason for Exemption
Declaration
I hereby declare that the information provided above is true and correct.
Applicant Signature
Date