1.      Fill in applicant’s name.

2.      Under column “Declaration”, delete what is not applicable.

3.      Under column “Type of Audits/Review Required:”,  tick “Annual Audit ”.

4.      Under column “Type of Certification required”, tick “Document of Compliance”.

5.      Propose date for the Audit in “Proposal date for review/audit: “, state the date you want the audit to be conducted.

6.      Initial and fill up the requested information.

7.      For questionnaires 1 to 5, please provide the latest information as requested. Should the space provided is insufficient, you may enclosed the information in separate attachment.

8.      “RO issuing SMC” refers to the Recognised Organisation that issues the Safety Management Certificate (SMC) to that particular ship.

9.    For questionnaire 6 – (attachments), only if any necessary.

10.  Completed form may be submitted via fax (+603-3168 4454) or e-mail to ism@marine.gov.my or by hand to Principal Assistant Director, Ship Safety Management Unit.

11.  For case to case basis, we may require the Company to submit further information.