C172 

 App. 



SAFETY OF LIFE AT SEA 



Appendix 



Form of Safety Certificate for Passenger Ships 

 PASSENGER SHIP SAFETY CERTIFICATE 



(Official Seal) 



for international voyage. 



a short 



{Country) 



Issued under the provisions of the 

 International Convention for the Safety of Life at Sea, 1960 



Particulars of Date on which 

 Name of Distinctive Gross voyages, if any, keel was laid 



Ship Number or Port of Registry Tonnage sanctioned under (see Note 



Letters Regulation 27 (c) below) 



(vi) of Chapter III i 



The 



(Name) Government certifies 

 I, the undersigned (Name) certify 



I. That the above-mentioned ship has been duly surveyed in accordance 

 with the provisions of the Convention referred to above. 



II. That the survey showed that the ship complied with the requirements 

 of the Regulations annexed to the said Convention as regards: — 



(1) the structure, main and auxiliary boilers and other pressure vessels and 



machinery; 



(2) the watertight subdivision arrangements and details; 



(3) the following subdivision leadlines: — 



Subdivision loadiines ussigned and 



marked on the ship's side at 



amidships (Regulation 11 of 



Chapter II) 



To apply when the spaces in which 

 Freeboard passengers are carried included the 



following alternative spaces 



C. 1 

 C. 2 

 C. 3 



App. 



