Republic of the Philippines

Department of Transportation

MARITIME INDUSTRY AUTHORITY

PUBLIC OF THE PHILIPPI
Bonifacio Drive corner 20th Street, Port Area, Manila

CERTIFICATE OF OWNERSHIP
(Private / Commercial Use)

THIS IS TO CERTIFY THAT pursuant to Section 10 of Republic Act No. 9295, Section 12 of
Executive Order No. 125-A and Memorandum Circular No. DS-2019-01, ______________,
having made the required declaration, deposes and says that:

Owner/ Company Business Address Nationality

is the owner/operator of the herein named and described vessel.

GENERAL PARTICULARS
Name of Vessel Body Number Call Sign Official No.

Type of Recreational Boat Builder Place Built Year Built

Hull Material Length (Meter) Breadth (Meter) Depth (Meter)

No. of Engine/s Engine Make Serial Number/s Kilowatt (KW)

Issued by the Authority of the Government of the Philippines under my hand and seal at
MANILA this 31st day of July 2019 and is valid until 30 July 2024.

By the Authority of the Administrator:

(Per AO No. 11-14 dated 22August 2014
and SO No. 1531-18 dated 13 August 2018)

LIBERTY R. LINGAD
Officer-in-Charge
Domestic Shipping Service

Amount Paid: P Note: This cancels and supersedes Certificate of Ownership No. REG-028203 issued by the Maritime Industry
Paid Under O.R. No.: Authority dated 05 November 2010 Certificate of Ownership No. REG-0081771 issued by the Maritime Industry Authority da
Date:
Note: This cancels and supersedes
This cancels and supersedes Certificate of Ownership No. REG-0057169 issued by the Maritime Industry Authority dated 0

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