This form lets us know that you are medically fit for working at sea. This form replaces Incident report form 529. This form lets us know that you are medically fit for working at sea. MEDICAL FITNESS CERTIFICATE FOR A NEAR COASTAL QUALIFICATION – AMSA 559 Marine Safety (Domestic Commercial Vessel) National Law Act 2012. Given names. Additional information . This form is for interested third parties, such as pilots, stevedores, port authority officers and other parties. Country. B. Date of birth. Town/suburb. Postcode. AMSA form 559 is used for domestic or near coastal qualification applications.
You are not required to complete this form when using the AMSA 426. Do you have unclear speech or hesitation when you speak? This form may be used by the owner of a domestic commercial vessel to authorise the release of vessel records to an accredited marine surveyor for the purposes of undertaking a vessel survey. amsaconnect@amsa.gov.au. Title.
This form is to be used when directed by AMSA. For international marine qualifications use You will need a certificate of medical fitness if you are applying for:Section A of the form is for you to complete your details.Sections B, D and E must be completed by a qualified medical practitioner.Fill out your details in section A and take the form and the guidelines with you to your qualified medical practitioner. Email. Street number and name. State . Nationality. Guidance on when to use this form. Find your certificate of competency in We use this information to improve our website, and it is not intended as a customer service channel. Marine Order 505 (Certificates of competency – national law) 2013 . This form is also available as a web form that you can submit directly to us online. Use this form to report a marine incident.
AMSA form 303 is used for international marine qualifications. Title . Surveyors can use this form to make a recommendation after conducting a commissioning, periodic, or out of water survey of a domestic commercial vessel. How to complete this form . AMSA form 559 is used for domestic or near coastal qualification applications. You can use this form to apply for a free Australian maritime mobile service identity (MMSI) number, if you own the following types of equipment aboard a recreational or commercial... You can use this Commonwealth provided template to make a declaration under the Statutory Declarations Act 1959. Download and complete the word form, or use the online version of this form in the link above. This form is also available as a web form that you can submit directly to us online.
You must provide them with a proof of identity which may include a:Give the medical practitioner the Guidelines for the medical assessment of near coastal seafarers.
Outside of Australia +61 2 6279 5000. Address. Surname. 82 Northbourne Avenue Braddon ACT 2612 Australia. AMSA form 559 is used for domestic or near coastal qualification applications. Phone - other. Emergencies. If you require assistance with AMSA services, please contact For international marine qualifications use AMSA form 303 . Medical declaration. For international... Use this form to alert us of a marine incident. For domestic or near coastal qualification applications use AMSA form 559 . Either the owner or accredited marine surveyor is able to lodge this form with the marine safety agency where the vessels most recent survey records are maintained. 1800 406 406 Monday to Friday 9 am to 5 pm. Beacons enquiries. Find out how to obtain a Certificate of …
This Eyesight test certificate form 542 lets us know that your eyesight meets the necessary standard for working at sea. You can use this form to complete a medical examination report. When do I need an eyesight test certificate? Submit your completed form by emailing it to reports@amsa.gov.au. If you answered 'Yes' to any question other than the eyesight question in the medical declaration, a copy of a current and valid Certificate of Medical Fitness for a Marine Qualification (AMSA 559) must be attached to this application. Phone - primary. State . They will need to:Specific requirements for your certificate of competency can be found on the page for that certificate. This form lets us know that you are medically fit for working at sea. You can use this form to lodge a bill of sale for a vessel. This form lets us know that you are medically fit for working at sea. AMSA form 559 is used for domestic or near coastal qualification applications. Submitting the form .