修正连续概要纪录（CSR）文件号码.doc

修正連續概要紀錄(CSR)文件號碼 AMENDMENTS TO THE CONTINUOUS SYNOPSIS RECORD (CSR) DOCUMENT NUMBER 船舶IMO編號 FOR THE SHIP WITH IMO NUMBER： IMOXXXXXXX 日期格式應為年/月/日 Dates should be in the format yyyy/mm/dd. 資訊Information 1 本份文件開始適用日期This document applies from (date): (此欄由主管官署填寫，請留白即可) 2 船旗國Flag State: (請填寫船旗國家名稱) 3 開始登記於第2項所示國家的日期Date of registration with the State indicated in 2: (請填寫船舶國籍證書之登記日期) 4 船名Name of ship: (請參考船舶國籍證書) 5 船籍港Port of registration: (請參考船舶國籍證書) 6 目前登記所有人Name of current registered owner(s): (請參考船舶國籍證書) 登記地址Registered address(es): (請參考船舶國籍證書) 7 登記所有人識別碼Registered owner identification number: (依據申請識別碼填寫) 8 目前登記光船租賃人(適用時)If applicable, name of current registered bareboat charterer(s): 登記地址Registered address(es): 9 公司名稱(國際安全管理)Name of Company (International Safety Management): (請參考公司符合文件) 登記地址Registered address(es): (請參考公司符合文件) 安全管理活動地址(若與登記地址不同時填寫)Address(es) of its safety management activities (if different from registered address): (請參考公司符合文件) 10 公司識別碼Company identification number: (依據申請識別碼填寫) 11 船舶所屬船級協會Name of all classification societies with which the ship is classed: CR Classification Society (若為雙船級請一併填寫) 12 簽發符合文件的主管機關 / 政府 / 認可機構Administration / Government / Recognized Organization which issued Document of Compliance: CR Classification Society 執行稽核的單位(與上述不同時填寫)Body which carried out audit (if different): 13 簽發安全管理證書的主管機關 / 政府 / 認可機構Administration / Government / Recognized Organization which issued Safety Management Certificate: CR Classification Society 執行稽核的單位(與上述不同時填寫)Body which carried out audit (if different): 14 簽發國際船舶保全證書的主管機關 / 政府 / 認可保全機構Administration / Government / Recognized Security Organization which issued International Ship Security Certificate: CR Classification Society 執行驗證的單位(與上述不同時填寫)Body which carried out verification (if different): 15 船舶停止登記於第2項所示國家的日期Date on which the ship ceased to be registered with the State indicated in 2: (依據除籍證明填寫) 16 備註(適用時填入相關資訊)Remarks (i