Maritime Mutual Insurance MLC Certificates Application
This document is an application form for MLC Certificates of Financial Security under the Maritime Labour Convention 2006 as amended. It includes undertakings and agreements made by the applicant. The form must be filled out and submitted as per the instructions provided.
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How do I fill this out?
To fill out this form, you will need to provide details about the vessel and the registered owner. Ensure you read the undertakings carefully before signing. Follow the steps provided in the detailed section to complete the form accurately.

How to fill out the Maritime Mutual Insurance MLC Certificates Application?
1
Enter the ship name(s), port of registry, call sign, and IMO number.
2
Provide the registered owner's name and contact information.
3
Specify the period for which you are requesting the MLC Certificates.
4
Read and agree to the undertakings, ensuring compliance with the terms.
5
Sign the form on behalf of the member and all joint entrants.
Who needs the Maritime Mutual Insurance MLC Certificates Application?
1
Shipowners seeking MLC Certificates for their vessels.
2
Maritime companies requiring proof of financial security compliance.
3
Authorized representatives applying on behalf of joint entrants.
4
Insurance brokers managing maritime insurance policies.
5
Legal advisors ensuring adherence to MLC regulations.
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What are the instructions for submitting this form?
To submit this form, ensure all required fields are filled out accurately. You can submit the form via email to info@maritime-mutual.com, fax it to +423 237 6910, or send it through the postal mail to Maritime Management Establishment, Landstrasse 36, 9495 Triesen, Liechtenstein. For online submissions, visit maritime-mutual.com and use the online form submission feature. It is recommended to keep copies of the completed form and submission receipts for your records and follow up if necessary.
What are the important dates for this form in 2024 and 2025?
The important dates for submitting this form are before the expiration of the current MLC Certificates period for 2024 and 2025. Ensure submission well in advance to maintain compliance.

What is the purpose of this form?
The purpose of this form is to apply for MLC Certificates of Financial Security under the Maritime Labour Convention 2006 as amended. These certificates are crucial for demonstrating compliance with international maritime labor standards. Completing and submitting this form ensures that the vessel and its owner meet the necessary financial security requirements.

Tell me about this form and its components and fields line-by-line.

- 1. Ship Name(s): The name or names of the ship(s) for which the MLC Certificates are being requested.
- 2. Port of Registry: The port where the ship is registered.
- 3. Call Sign: The call sign of the ship used for radio communications.
- 4. IMO Number: The unique identification number assigned to the ship by the International Maritime Organization (IMO).
- 5. Registered Owner: The name of the individual or entity that legally owns the ship.
- 6. Period: The start and end dates for which the MLC Certificates are being requested.
- 7. Undertakings: A set of agreements and declarations made by the applicant regarding compliance with the MLC Extension Clause 2019 and other relevant terms.
- 8. Signature: The form must be signed by the member or an authorized signatory on behalf of all joint entrants.
What happens if I fail to submit this form?
Failure to submit this form can result in non-compliance with the Maritime Labour Convention regulations.
- Regulatory Penalties: The ship may face fines or penalties for not having the required MLC Certificates.
- Operational Disruptions: The ship may be detained or face operational delays until compliance is achieved.
- Legal Liabilities: The ship owner may incur additional legal liabilities for failing to meet regulatory requirements.
How do I know when to use this form?

- 1. New Certificates: When applying for new MLC Certificates for a vessel.
- 2. Renewal of Certificates: When renewing existing MLC Certificates before they expire.
- 3. Compliance Verification: When verifying compliance with MLC regulations for financial security.
- 4. Change of Ownership: When there is a change in the ship's registered ownership and new certificates are required.
- 5. Flag State Requirements: When required by the flag state authorities to provide updated MLC Certificates.
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What type of information do I need to provide in the form?
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