ISM / HSQE CERTIFICATION
Overview
 
Request for Proposal    
>
 Request for Audit    
  Request for Audit :
Request for Ship Audit

(Note: Fields marked with an asterisk * are required)
* 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 Here to Pick the date (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
   
   
Agent's Name:
Agent's Address:
Agent's Tel:   Agent's Fax:   Agent's Email:
   
Is the Vessel currently ISM/ISPS certified by RO (class society) other than ABS: YES      NO
If yes, name of the RO that has issued the existing certificate(s): SMC:
ISSC:
   
Audit Type 1
Audit Type 2 (if applicable)
a)
ISM     ISPS		 a)
S    SH    SQ    SE
SHQ    SHE    SQE    HSQE
SEC Notation (ABS Guide Requirements)
b)
Initial    Annual    Intermediate
Renewal    Follow Up    Additional  
Interim    Pre-Assessment 		b)
Initial    Annual    Intermediate
Renewal    Follow Up    Additional
Pre-Assessment
   
Name of Ship:
   
Name & Address of Company:
(as it appears on your DOC)
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.
   
Doc Issued by:
(for ISM/HSQE)
Ship Security Plan Approved by:
(for ISPS)
Flag:    Ship's ABS Class Number:
   
Following section must be filled out if the vessel is not ABS classed:
Class Society:
Class Ship Type:
Distinctive Number
or Letters :
IMO Number :
IMO Ship Type:
(Check applicable ship type)
Passenger Ship Oil Tanker Bulk Carrier
Passenger High Speed Craft Chemical Tanker Other Cargo Ship
Cargo High Speed Craft Gas Carrier MODU
Gross Tonnage:
Year Build:
Builder Name:
Hull Number: