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INTERNATIONAL FISHING VESSEL
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EXEMPTION CERTIFICATE
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(Official seal)
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(State)
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| Issued under the provisions of the
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| TORREMOLINOS PROTOCOL OF 1993 RELATING TO THE
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| TORREMOLINOS INTERNATIONAL CONVENTION
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| FOR THE SAFETY OF FISHING VESSELS, 1977
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| under the authority of the Government of
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| ____________________________________
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(name of the State)
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| ____________________________________
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| by
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(person or organization authorized)
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Particulars of vesselfootnote
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| Name of vessel . . . . . . . . . . . . . . . . . . .
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| Distinctive number or letters . . . . . . . . . . . .
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| Port of registry . . . . . . . . . . . . . . . . . .
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| Length (L)2
footnote. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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.
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| THIS IS TO CERTIFY:
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| That the vessel is, under the authority conferred by
regulation . . . . . . . . . . . . . . . . . . . . . . . . . . . exempted
from the requirements of . . . . . . . . . . . . . . . . . . . . . . . . . .
. .
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| Conditions, if any, on which the Exemption
Certificate is granted:
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| . . . . . . . . . . . . . . . . . . . . . . . . . . .
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| This certificate is valid until . . . . . . . . . .
. . . . . . . . . . . . . . subject to the International Fishing Vessel
Safety Certificate, to which this certificate is attached, remaining
valid.
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| Issued at . . . . . . . . . . . . . . . . . . . . . .
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(Place of issue of certificate)
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. . . . . . . . . . . . . . . . . . . . . . . . . . .
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(Date of issue)
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(Signature of authorized official issuing the certificate)
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(Seal or stamp of the issuing authority, as appropriate)
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ENDORSEMENT TO EXTEND THE VALIDITY OF THE
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CERTIFICATE FOR A PERIOD OF GRACE WHERE
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REGULATION I/11(1) APPLIES
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| This certificate shall, in accordance with regulation
I/11(1), be accepted as valid until . . . . . . . . . . . . . . .
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Signed; . . . . . . . . . . . . . . . . . . . . . . .
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(Signature of authorized official)
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Place: . . . . . . . . . . . . . . . . . . . . . . . .
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Date: . . . . . . . . . . . . . . . . . . . . . . . .
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(Seal or stamp of the authority, as appropriate)
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ENDORSEMENT TO EXTEND THE VALIDITY OF THE
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CERTIFICATE UNTIL REACHING THE
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PORT OF SURVEY OR FOR A PERIOD
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OF GRACE WHERE REGULATION I/11(2)
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OR REGULATION I/11(4) APPLIES
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| This certificate shall, in accordance with regulation
I/11(2)/regulation I/11(4)
footnote, be accepted as valid until . . . . . . . . . . . . . . .
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Signed; . . . . . . . . . . . . . . . . . . . . . . .
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(Signature of authorized official)
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Place: . . . . . . . . . . . . . . . . . . . . . . . .
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Date: . . . . . . . . . . . . . . . . . . . . . . . .
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(Seal or stamp of the authority, as appropriate)
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