Page 1 of 2 Rev 01-03 Template 05

of 2 Rev 01-03 template 05 BARBADOS SECOND SCHEDULE

SHIP PARTICULARS Shipping Act, 1994

To be used for those ships measured in accordance With the MS (Tonnage) Regulations, 1982, Part II Name of Ship Port of intended Registry BRIDGETOWN

Official Number ( of former Registry) if any Whether Sailing, Steam or Motor. ( if Steam or Motor how propelled)

Dimensions Metric Units Name and Address of Builders

Length

Breadth

Moulded depth

Moulded draught

Where built Date keel was laid Date measured Type of Ship

Material used to construct hull Number of passengers for whom accommodation Is certified in cabins of not more than eight berths

Number of other passengers

Number of seaman and apprentices for whom accommodation is certified These dimensions are to be as defined in the Merchant Shipping (Tonnage) Regulations, 1982 under Part1

PARTICULARS OF TONNAGE The Tonnages of this ship, in accordance with her International Tonnage Certificate (1969) are :

GROSS TONNAGE …………………………………………… NET TONNAGE …………………………………………….

A summary of the spaces included and excluded from the tonnages are shown in the International Tonnage Certificate 1969

I the undersigned Surveyor appointed by the Minister responsible for Shipping hereby certify that the above particulars are true, and that her name is marked clearly on each of her bows, and her name and port of registry are properly marked on a conspicuous part of her stern, and her scale of decimetres, metres and decimetres are marked one each side of her stern post in a manner directed by the Shipping Act 1994 as amended.

Dated at ……………………… this ……………………………..day of …………………………………20 ………..

Signature……………………………………………. . name ……………………………………………….. Owners Representative Page 2 of 2 Rev 01-03 template 05

CERTIFIED EXTRACTS OF PARTICULARS SUPPLIED BY BUILDERS, OWNERS OR ENGINE MAKERS

PARTICULARS OF PROPELLING ENGINES (if any)

No. of sets of engines …………………………………………………………….. ………………………………………………………………………………

No. of shafts ………………………………………………………………………… ………………………………………………………………………………

Description of engines ………………………………………………………………. ………………………………………………………………………………

When made ………………………………………………………………………….. ………………………………………………………………………………

Name and address of makers ……………………………………………………. ………………………………………………………………………………

RECIPROCATING ENGINES

No. of cylinders in each set ………………………………………………………. …………………………………………………………………………….

Diameter of cylinders .…………………………………………………………….. ………………………………………………………………………………

Length of stroke .…………………………………………………………………… ………………………………………………………………………………

ROTARY ENGINES

No. of cylinders in each set ……………………………………………………… ………………………………………………………………………………

PARTICULARS OF BOILERS

Description …………………………………………………………………………… ………………………………………………………………………………

Number ……………………………………………………………………………….. ………………………………………………………………………………

Working pressure ……………………………………………………………………. ………………………………………………………………………………

When made …………………………………………………………………………… ………………………………………………………………………………

Name and address of makers ………………………………………………………. ………………………………………………………………………………

………………………………………………………………………………

Estimated brake or shaft power (kW) ……………………………………………. ………………………………………………………………………………

Estimated speed of ship ………………………………………………………….. ………………………………………………………………………………

………………………………………………………………………………

Owner’s Representative Signature