SHIP REGISTRY JSR-Y86 Page 1 of 2

YACHT NAME PROPOSAL AND RESERVATION1

1. PORT OF REGISTRY

PLEASE COMPLETE IN BLOCK LETTER

List alternative name(s) in order of preference in case the first name cannot be approved.

1ST 3RD 2ND 4TH

2. YACHT STATUS Is the yacht new? Yes No (if yes, please fill in A below, only)

A Name of Builder Address of Builder Yard No. allocated to this yacht:

B If the yacht is currently sailing under another flag, state flag:

Registered Name: Nationality Location of Yacht Proposed Registration Date (DD/MM/YYYY):

Method of Propulsion: Sail Steam Motor

Total Propulsion Engine (kw) Gross Tonnage:

3. OWNER’S DETAILS

Name of Owner Mailing Address

Telephone Email

Signature of Owner

1 NOTE: This form is to be forwarded to the Registrar of Ships where necessary, prior to the submission of the other registration forms /documents. If the vessel is not registered within ninety (90) days of the date of the name approval, the name will be made available for use by others. Upon further request however, the Registrar may renew the reservation for an additional term, if the name remains available.

JSR-Y86/Rev. No; 01/

4. REGISTRATION APPROVAL

has been reserved for ninety (90) days from Name of Yacht Date (dd/mm/yyyy)

Approved by the Registrar of Ship

Name of Registrar Signature of Registrar

PORT OF REGISTRY

The Official Port of Registry for Jamaican vessels is . Yachts have the option of selecting any of the following as a Port of Registry:

Annotto Bay Black River Falmouth Green Island Lucea Manchioneal Montego Bay St. Ann’s Bay Portland Bight Rio Bueno Savanna-La-Mar Discovery Bay Alligator Pond

JSR-Y86/Rev. No; 01/