ABS SESC - RFP

ISM / HSQE CERTIFICATION

Request for Audit :
Request for Company Audit

(Note: Fields marked with an asterisk * are required)

Audit Type 1	Audit Type 2 *(ABS Guide)
* ABS location nearest to where the audit should take place:
* Requestor's Name:
Tel:
Fax:
* Email:
Location of Audit:
Expected Audit Date: (if known)	(click on calendar to select date)
Please have the ABS Port Office contact me to schedule an Audit Date: (if Audit Date not known)	YES NO

Is the Company currently ISM certified by RO (class society) other than ABS:	YES NO
If yes, name of the RO that has issued the existing DOC:

a) ISM	a) S SH SQ SE SHQ SHE SQE HSQE SEC Notation (ABS Guide Requirements)
b) Interim Initial Annual Renewal Follow Up Additional Pre-Assessment	b) Initial Annual Renewal Follow Up Additional Pre-Assessment


Name & Address of Company:
Company IMO Number:
A unique Company identification number may be required to be posted on DOCs, SMCs and ISSCs. For more information on obtaining this number please visit LR Fairplay.

Additional Information (if any):


* If applicable. S, SH, SQ, SE, SHQ, SHE, SQE, and HSQE are notations of the ABS Guide for Marine Health Safety, QUality and Environmental Management. SEC is a notation of the ABS Guide for Ship Security.