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MALAYSIA SHIPOWNERS' ASSOCIATIONForm C
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DOMESTIC SHIPPING LICENSE CONSENT LETTER INFORMATION FORMOffshore
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Vessel
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√
Please tick in the relevant box.
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VESSEL REQUIREMENT:
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a)Vessel Name:
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b)Type of Vessel:
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Project Details
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a)Project Name:
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b)
Approval Reference Number
:
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c)Location :
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d)
Project Requirement
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Incase of cable ship, please provide the following information:
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e)
Fault Point Location With Coordinates
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 f)
ETA at Fault Point
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g)
Expected Repair Duration at Fault Point
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COMMENCEMENT DATE:
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a)Laycan:
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b)Duration (Days):
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DESCRIPTION OF VESSEL:
Critical Project Requirement
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(To indicate restriction if any)
(Tick in the box)
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a)Length
(min - max)
:YesNo
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b)Breadth
(min - max)
:YesNo
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c)Depth
(min - max)
:YesNo
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d)GRT
(min - max)
:YesNo
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e)NRT
(min - max)
:YesNo
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f)DWT
(min - max)
:YesNo
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g)Critical Specs for Project:
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APPLICANT'S DETAILS
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Applicant's Details
Charterer's Details
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a)Name:a)Name:
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b)Company:b)Company:
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c)Address:c)Address:
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d)Tel/Fax/Hp No.:d)Tel/Fax/Hp No.:
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e)Email Address:e)Email Address:
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f)MASA Member: f)MASA Member:
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YesNoYesNo
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