CHINA CLASSIFICATION SOCIETY

APPLICATION FOR SURVEYS OF SHIP IN SERVICE

Form AFC-1

No.

The undersigned requests CHINA CLASSIFICATION SOCIETY to carry out survey(s)/ to issue certificate(s) for the ship below and installations and the

undersigned agrees with the relevant CCS Rules/requirements and promises to provide drawings/adequate & safe survey condition as required by CCS

and bear all survey fee and expenses involved.

Ship Name CCS No.

Flag Type

Survey Place Survey Date

ApplicantContacts

Tel. Fax Email

AgencyContacts

Tel. Fax Email

Certificates Mailing Add.Contacts

Tel. Fax Email

Class Survey

Annual Survey ( Commenced/ Partial/ Completed)

Intermediate Survey ( Commenced/ Partial/ Completed)

Special Survey ( Hull/ Machinery/ Refrigerator) ( Commenced/ Partial/ Completed)

Continuous Survey ( Hull/ Machinery) Boiler Survey

Docking/ In-water Survey Occasional Survey

Screwshaft Survey ( Normal/ Partial/ Modified) Postponement for

PMS ( Initial Audit/ Annual Audit/ Implementation Survey) Damage Survey / Repair Survey

Others

Statutory Surveys Initial Annual Periodical Intermediate Renewal Additional

Load Line

Safety Construction

Safety Equipment

Safety Radio

MARPOL Annex I(Oil Pollution Prevention)

MARPOL Annex II

MARPOL Annex IV(Sewage Pollution Prevention)

Garbage Prevention

MARPOL Annex VI(Air Pollution Prevention)

Energy Efficiency

Dangerous Goods(SOLAS II-2/19)

IMSBC Code

IBC Code

IGC Code

Anti-Fouling

Passenger Safety

Navigation Safety

Ballast Water Management

Crew Accommodation

Cargo GearSurvey Before Operating Annual Annual Thorough

Quadrennial Load Test Additional

Others

Payment Terms Cash Cheque Bank Transfer

Note: Applicable Not Applicable

(Rev.6.3 20150301)

Signature and Stamp Date

Note: Applicable Not Applicable

(Rev.6.3 20150301)