LRIT Application Form


LRIT Application Form


 

 
Contact Details  
Authorising Flag State
If your Flag is not listed above, please contact us and we will request testing authorisation from your Flag.
Person to contact for testing
Contact Number
Contact Email

Billing Details
 
VAT Number (if registered)
Billing Company Name
Billing Address
Billing Country
Billing Email
Vessel & Equipment Details  
Equipment Type Inmarsat C Skywave
Satamatics Iridium
Equipment Manufacturer : Model
Inmarsat Mobile Number (IMN)
   
Equipment Serial Number
   
Vessel Name
Vessel IMO Number
Port of Registry
Distinctive Numbers or Letters
(call sign)
MMSI Number
Gross Tonnage
Sea Area Operation A1 A2 A3 A4
Vessel Certificate Type
Vessel Certificate Reference Number
New Build Yes No
Compliance Details  
This equipment is additionally used for GMDSS YES NO
This equipment is additionally used for SSAS YES NO
This equipment is compliant with provisions of resolution A.694(17) and the equipment has been tested for electromagnetic compatibility (refer to resolution A.813(19)) YES NO
This equipment is supplied with energy from the main and an emergency source of electrical power. YES NO
This equipment has an internal GPS or connected external GPS. YES NO
This equipment is type approved under the provisions of V/19-1. YES NO
This is a GMDSS terminal and therefore it is type approved under the provisions of IV/14. YES NO
This equipment is compliant with the requirements of IEC 60945 (2002-8) and IEC 60945 (2008-04). YES NO
This is the Ship Security Alert System (SSAS) and therefore complies with provisions of regulation XI-2/6 and resolution MSC.147 (77). YES NO

To the best of my knowledge the information I have given is accurate. This information will be used to create the Conformance Test Report. Any mistakes that later invalidate the Conformance Test Report may incur additional charges to reissue the Conformance Test Report.
 


Requested Testing Date

Do you wish to include payment for courier delivery of your CTR ? No
Yes enabled only if FMS provides the CTR