MSF 4227/ REV 0607

APPLICATION FOR A SAFE MANNING DOCUMENT

EXPLANATORY NOTES
With effect from 1 February 1997, the revised IMO Convention on Standards of Training, Certification and
Watchkeeping (STCW 95) came into force. New UK merchant Shipping (Safe Manning, Hours of Work and
Watchkeeping) Regulations 2002 specify the revised requirements for safe manning of ships over 500gt and you
are advised to read these and the advice given in Merchant Shipping Notice MSN 1767 and Parts 5, 6 and 10 of
the Guidance on Training and Certification before completing this application.

PLEASE COMPLETE IN BLOCK CAPITALS

1. PARTICULARS OF APPLICANT
Full name of owner

Address

Postcode

Name of applicant if not the owner

Address of applicant if not the owner

Postcode

Any further relevant details not adequately covered

2. PARTICULARS OF THE SHIP below should be included in a separate letter

Name of ship

Port of Registry Official Number

Year of build IMO Number

Type of ship

Principal dimensions (LOA x B x draught)

Unusual characteristics / features of ship

Tonnage 1. Gross 2. Max. summer deadweight

Auto Steering Yes / No* Details of hatch covers

External communications (tick as appropriate) W/T R/T VHF

Details of internal communications

* Delete as appropriate

1/7 Formerly MAN 1

 MSF 4227/ REV 0607

2. PARTICULARS OF THE SHIP (continued)

LSA class Number of Lifeboats

Area of Operation Near-Coastal (UK) Number of ILRs

(tick as appropriate)

Unlimited Number of ILR Davits

Number of Passengers Number of Rescue Boats

Restricted conditions (please specify)

Bow thruster Yes / No* Stern thruster Yes / No*

CP propeller Yes / No* Number of engine-room spaces

Number of main engines Registered power per engine (kW)

Type of engines Steam / Motor*

Steam Boilers (tick as appropriate) None Auto Manual

High bilge alarm system Yes / No* Bridge Control Yes / No*

Unattended Machinery Yes / No* Engine-room fire detection fitted Yes / No*
Space (UMS) Certificate
* Delete as appropriate

Details of engine-room / bridge communication system

3. INTENDED SERVICE
Please give details of the intended nature of service of the ship

4. MANNING SYSTEM (See Marine Guidance Note MSG 97(M) - Training and Certification Guidance - Part 10)

Please give details of the type of manning system

i.e. Conventional, General Purpose, Share System, Interdepartmental Flexibility or other

2/7
 MSF 4227/ REV 0607

Please submit your proposals for the safe manning of the above ship in the table below. (The tables at Annex 1 of
5. MSN 1682 provide guidance on the numbers of certificated deck and engineer officers appropriate to different
sizes of ships, tonnages and trading areas).

Near-Coastal* Unlimited
Master
Chief Mate
OOW (Deck)
Rating (Deck) Grade 1
Rating (Deck) Grade 2
Chief Engineer
2nd Engineer
OOW (Engineer)
Rating (Engine)
Cook
Doctor
Other (specify)
Rating (GP) Grade 1
Rating (GP) Grade 2

TOTAL (Minimum number of crew to be

* Near-Coastal - within 150 miles from a safe haven in the UK or 30 miles from a safe haven in Eire.

6. SUPPLEMENTARY INFORMATION
Merchant Shipping Notice MSN1767 must be read in conjunction with the details required in this section. This section
of the form is to be used by owners and managing operators as guidance in the assessment of proposed safe
manning levels, especially in relation to paras 2.2 and 2.3 of MSN1767.

(Additional sheets should be attached if the space provided is insufficient)

Describe anticipated trade or trades

Describe anticipated length and nature of voyages

Describe the anticipated geographical trade areas

3/7
 MSF 4227/ REV 0607

6. SUPPLEMENTARY INFORMATION (Continued)

Detail how the following capabilities will be covered:

1. Maintain a safe bridge watch at sea in accordance with Regulation VIII/2 of STCW 95, which includes
general surveillance of the vessel.

Which watch system will be adopted? TWO / THREE* (* Delete as appropriate)

Will the Master undertake a navigational watch? YES / NO*

Will the Master be required to undertake his/her own pilotage? YES / NO*

Are office to ship communications handled only by the Master? YES / NO*

What is the communication system between bridge & watch rating?

2. Moor and unmoor the vessel effectively and safely

Are self-tension mooring winches fitted to the vessel? YES / NO*

Detail mooring station equipment and manning requirements for peak workload situation:

Forward

Aft

3. Operate and, when practicable, maintain efficiently, all watertight closing arrangements, fire equipment
and life-saving appliances provided, including the ability to muster and disembark passengers and non-
essential personnel (as appropriate), and mount an effective damage control party.

Is the vessel fitted with an accommodation fire detection system? YES / NO*

Are fire pumps started remotely? YES / NO*

Who is responsible for equipment maintenance?

Describe the lifeboat and rescue boat launching systems (as appropriate)

State how fire/damage control/LSA requirements are covered

4. Manage the safety functions of the vessel at sea, when not under way.

Does the vessel have DP capability? YES / NO*

4/7
 MSF 4227/ REV 0607

6. SUPPLEMENTARY INFORMATION (Continued)

5. Maintain a safe engineering watch at sea in accordance with Regulation VIII/2 of STCW 95, and also
maintain general surveillance of spaces containing main propulsion and auxiliary machinery.

Will a watch system be adopted? YES / NO* (* Delete as appropriate)

Which watch system will be adopted? TWO /

Is there a UMS Certificate in operation? YES / NO*

Are all machinery spaces covered by a fire detection system? YES / NO*

Are all machinery spaces covered by a bilge alarm system? YES / NO*

Will the Chief Engineer undertake a watch? YES / NO*

Can emergency steering be engaged by one person? YES / NO*

How will the engineer watch rating duties be covered?

6. Operate and maintain in a safe condition, the main propulsion and auxiliary machinery to enable the ship
to overcome the foreseeable perils of the voyage, and maintain the safety arrangements and cleanliness of
machinery spaces to minimise the risk of fire.

Who will undertake machinery space cleaning?

Who will assist in the event of breakdowns?

7. Provide for medical care onboard.

How is the provision satisfied?

8. Maintain a safe radio watch in accordance with 1974 SOLAS and ITU Regulations, as amended.

What is the radio equipment maintenance agreement? ONBOARD / SHORE BASED*

Who will be the primary GMDSS operator?

9. Maintain the precautions and safeguards necessary to protect the marine environment in accordance with
MARPOL 73/78, as amended.

What personnel are necessary to cover the vessels SOPEP requirements?

5/7
 MSF 4227/ REV 0607

6. SUPPLEMENTARY INFORMATION (Continued)

10. Maintain safety in all ship operations whilst in port.

What cargo handling gear is fitted to the vessel and who operates it?

Who undertakes hold/tank cleaning?

11. Ships Cook

Will a certificated ships cook be carried? YES / NO* (* Delete as appropriate)

If not, how will the cooking duties be covered?

12. Ships Doctor

With respect to the M.S. (Ships Doctors) Regulations 1995, S.I. 1995/1803, state compliance (as appropriate):

(UK ships are required to have a doctor on board if carrying 100 or more persons on an international voyage of more than
three days, or on a voyage during which it is more than one and a half day's sailing time from a port with adequate
medical equipment)

HOURS OF WORK PROVISION

Provide an explanation of how the proposed manning level takes account of the requirements contained in the M.S.
(Safe Manning, Hours of Work and Watchkeeping) Regulations 2002, ensuring that the working arrangements allow
for sufficient rest periods to avoid fatigue:

7. PLANS SUBMITTED WITH THIS APPLICATION (tick as appropriate)

Fire Mooring & equipment Escape (Passenger ships only)

Schedule of duties General arrangement Engine-room arrangement

6/7
 MSF 4227/ REV 0607

8. DECLARATION (The maximum penalty for a false entry is £5000)

I declare that to the best of my knowledge, the particulars given by me on this form are correct.

Signed (on behalf of the owners) Date

Please now complete the PAYMENT DETAILS in Section 8 below

The completed form together with the appropriate fee and enclosures should be sent to:

Maritime and Coastguard Agency

Seafarer Training and Certification
Spring Place
105 Commercial Road Tel 02380 329231
Southampton SO15 1EG Fax 02380 329252

9. PAYMENT DETAILS (To be completed by applicant)

Please tick ( ) the appropriate box below to indicate your chosen method of payment. CASH WILL NOT BE ACCEPTED

Maestro Visa Mastercard / Access Delta Cheque/bankers draft Postal Orders

Name of Card Holder Security Code

Card Number
(The Security
Start Date Code is the last
Expiry Date three digits of
the numbers on
Maestro Issue Number (Maestro Cards only) the reverse of
the card, near to
the signature

Signature Date

ALTERNATIVELY - If you have a Rolling Account with the MCA, please provide the following information:-

Client Reference Number

Marine Office where
Account is held
Customer Service

FOR OFFICIAL USE ONLY

Fee received by

File reference MC49/48/

F264
Official Stamp

An Executive Agency of the Department for Transport 7/7