INSTRUCTION TO FILL UP APPLICATION FORM : INITIAL RENEWAL AUDIT

(Note : Initial and renewal audit require two days of audit)

1. Fill in applicant’s name.

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

3. Under column “Type of Audits/Review Required:” , tick “Initial / Renewal Audit ” and delete what is not applicable.

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

5. Propose date for the Audit in coulom“Proposal date for review/audit: “.

6. Initial and fill up the requested information.

7. For questionnaire 1 to 4, please fill up the latest information requested. Should the space provided insufficient, please attached accordingly.

8. For questionnaire 5, the Company is required to fill up the coulom provided. The Company may also attach a separate form that contains at least the requested information.

9. “RO issuing SMC” referring to any Recognised Organisation that issues the Safety Management Certificate (SMC) to the particular vessel.

10. For questionnaire 6 – (attachments), no attachment is required.

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

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