Add missing information or correct errors
Add information about the seafarers identitydocument
Enter the relevant information about the holder here.
Enter information about the type of identification the holder is using for identification purposes.
Provide a permanent address for the seafarer
Please provide a delivery address
This is the place the holder is registered on. Please use the “place of delivery” field if you would like the endorsement to be delivered to a different address.
Enter the name and address of the recipient (person or company) of the endorsement. If the endorsement is to be sent to the shipping company, this address must be entered here.
Select if this is a first time application or duplication of an existing endorsement
Use the drop-down menu to find the certificate which you would like to apply for. If you are about to apply for several certificates, you will need to submit a form for each certificate.
Use the drop-down menu to find the consulate to verify this application.
Provide information about the national certificate below
Please enter the information about the national certificate in question.
Fill inn verification information
If the appropriate verification authority does not exist in the list, please register
Enter the information about the entity which may verify the certificate of the holder.
Please use the checklist to ensure that all enclosed with the application. In order to facilitate processing, please
do not send any documents other than the ones listed below.
Please note that both the holder’s signature as well as the photo must be submitted as jpg-files. If the signature or photo is stored in a pdf format, you will need to create a new file by performing a new scan or converting the pdf-file.
Please fill inn information about who you are or who you are sending this form on behalf.
Please fill inn additional information about this application.
Write down the text shown in the image to verify that this is not an automatically generated form submission.
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