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STATEMENT OF QUALIFICATION FOR VESSEL REGISTRATION
NOTE 1
1. Owners of one or more vessels registered or to be registered in the Small Vessel Register are required to complete only one Statement of Qualification.
2. As there is no "Name of vessel" and "Port of registry" for vessels in the Small Vessel Register, these fields should not be completed.
I understand that every person who provides false or misleading information commits an offence under Section 37 of the Canada Shipping Act, 2001.
Official number Name of vessel Port of registry
Owner's full name and address
Telephone number Cell number Fax number E-mail address Certificate in (select one)
English French STATE AS FOLLOWS (select one)
INDIVIDUAL
CORPORATION
FOREIGN CORPORATION
INDIAN BAND
I am a Canadian citizen or a permanent resident within the meaning of Subsection 2(1) of the Immigration and Refugee Protection Act.
A corporation incorporated under the laws of Canada and existing as per those laws at the time of this application.
A corporation incorporated under the laws of a Province and existing as per those laws at the time of this application.
Note: Partnerships are not accepted.
A vessel that is owned by a corporation incorporated under the laws of a country other than Canada.
An Indian Band registered with the Department of Indian and Northern Affairs.
The Individual, Corporation or Indian Band is entitled to be registered as (select one)
owner of shares¹ in the vessel; OR joint owner of shares¹ in the vessel with those whose names are listed below.
LIST OF OTHER JOINT OWNER(S) (if applicable) Full name(s) and address(es)
¹ 64 shares represent 100% ownership of a Canadian vessel INDIVIDUAL
Signature Date Statement signed (dd-mm-yyyy)
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Official number Name of vessel Port of registry
CORPORATION I
Name and title (Print)
state that I have authority to bind
Name of corporation (Print)
.
I also state that
Name of corporation (Print)
is the name of a corporation which legally exists at the date of this Statement of Qualification:
as per the laws of Canada; OR as per the laws of
Name of province/state (Print)
.
This Statement of Qualification must be signed by any Officer or Director of the corporation who has the authority to bind the corporation. Pursuant to Sections 51(2) and 75.01(2) of the Canada Shipping Act, 2001 applicants may be required to provide additional information as requested by the Chief Registrar.
I understand that it is an offence for a person to knowingly make a false or misleading statement in writing and that the penalty can be a fine or imprisonment or both if found guilty in a court of law (Section 37 of the Canada Shipping Act, 2001).
Signature of Officer or Director Date Statement signed (dd-mm-yyyy)
INDIAN BAND
Name of Indian Band (Print) Signature
Name of person signing above (Print)
Date Statement signed (dd-mm-yyyy)
SEAL
NOTE 2
1. If there is more than one owner, whether individual or joint, a separate Statement of Qualification must be completed by each owner.
2. Qualifications to own a vessel registered in Canada are set out in the Interpretation section of the Canada Shipping Act, 2001.
3. In the case of an Indian Band, the Statement of Qualification must be made by person(s) authorized by Band Council Resolution OR by affixing the seal of the Indian Band on this form.
The information you provide on this form is collected by Transport Canada for the purpose of registering your vessel. It is collected under the authority of Section 43 of the Canada Shipping Act, 2001. The registration of your non-pleasure (commercial) craft is mandatory unless it is registered in a foreign state. The information will be held in the Department's Personal Information Bank entitled Canadian Register of Vessels (bank number TC PPU 041). The information will be retained for 5 years after vessel is deregistered then destroyed. Your information will be handled in accordance with the provisions of the Privacy Act.
Instructions for obtaining your personal information are provided in Info Source, a copy of which is available in major public and academic libraries. Please note that under Section 76 of the Canada Shipping Act, 2001, a person may examine or obtain copies of any entries in the Register with respect to a vessel.
