Bijlage 1 Regeling bescherming koopvaardij: permission Application Form

Regeling bescherming koopvaardij

To be completed by the shipping company; for Dutch flagged vessels with registration in the Netherlands only. For VPD-protection of vessels with registration in Curaçao please contact Maritime Authority Curaçao. This application must be submitted to the following email address: bbk@kustwacht.nl The statutory timeframe [48 hours, weekends excluded] in which the Coastguard must make its decision on an application for armed private security will start once it receives this form, fully completed; attachments included. For Coastguard use only: Contact: Nautisch Beheer/ WtBK e-mail: bbk@kustwacht.nl Date: Time: KW dossiernr: Urgency: □ Immediate response by Coastguard within 24 hours preferred? Reason: PART 1 – GENERAL INFORMATION Details Remarks 0 Registration Dutch flag Yes □ No □ If ‘No’ Cancel request. This procedure is only applicable in case of Dutch flagged vessels. 1 Company name Applicant must qualify as a ship manager under the Merchant Shipping (Protection) Act 2 Address 3 Areal code 4 City 5 Name of contact person(s) 6 E-mail 7 Telephone 8 Name of ship 9 Call sign 10 IMO number 11 Type of ship E.g. tanker, dry cargo, passenger ship, RoRo 12 Photo of a side view of the ship □ Photo attached 13 Number of crew members 14 Attach copy of ship’s general plan (including accommodation plan) □ Copy of plan attached Voyage Details Details Remarks 15 Dates of transport: 1: Start [ETD] 2: End [ETA] 1: 2: 16 Last port of departure before the Risk Area 17 First port of arrival after the Risk Area 18 Intended route: Attach waypoint list. [RTZ, CSV, or Excel] □ Lat/Long WGS84 [ex. 29° 40 100N / 32° 33 200 E] PART 2 – INITIAL RISK ANALYSIS OF THE TRANSPORT to be completed by the Company Security Officer Details Remarks 19 Tonnage (Deadweight or Gross Tonnage) □ DWT: □ GT: 20 Free board on the Risk Area passage (metres/decimetres) 21 Maximum speed 22 Cruising speed during transport 23 Time expected to be in the Risk Area: 1: ETA RA 2: ETD RA 3: Total time in (H)RA 1: 2: 3: 24 M