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VESSEL DETAILS |
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| Name: | Keel laying date: | ||
| IMO Number: | GT: | ||
| Flag: | I | Call Sign: | |
| Class: | MMSI: | ||
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VDR/S-VDR DETAILS |
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| Check the suitable box: | Full VDR SystemüS-VDR System |
| VDR/S-VDR Manufacturer and type: | |
| VDR/S-VDR Serial Number: | |
| Date of Installation: | |
| Type of Capsule: | |
| Type of Beacon: | |
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VDR/S-VDR CONDITION |
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| Indicate any present or recent alarms displayed by the VDR/S-VDR | |
| Indicate the last replacement date of the VDR/S-VDR internal back up batteries. | |
| Indicate the expiration date of the beacon | |
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REPORT OF ANY DEFICIENCIES |
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CONTACT DETAILS |
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| Provide a postal address where the Certificate of Compliance can be sent if the APT is successful. | |
Important Notes:
- Please make sure all navigational equipment is switched on 12 hours prior to the scheduled time for the APT.
- Failure to complete this form and report accurately may result in the APT having to be stopped until such time as any found deficiencies are corrected.

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