ctr

Conformance Test Request

Revisada el 09/01/2023

For Honduran Flag Vessel

Date

Your name

Email

Web Address

Phone Number

WhatsApp Number

Acting as?

Billing Detail

Billing Company Name

Billing Address

Billing Country

BillingEmail

Billing phone

The Ship

Shipowner name

Ship Name

IMO Number

Call Sign

Registry Number

Type of vessel

MMSI Number

GRT

Port of Registry

Vessel Equipment Detail

Select an option

INMARSAT IRIDIUM

Equipment Serial Number

IMN

Ship area of operation

A1 A2 A3 A4

Compliance Details

This equipment is addionally used for GMDSS

Yes No

This equipment is addionally used for SSAS

Yes No

This equipment is compliant with provisions of resolution A.694(17) and the equipment has been tested for electromagnetic compatibility (refer to resolution A.813(19))

Yes No

This equipment is supplied with energy from the main and an emergency source of electrical power.

Yes No

This equipment has an internal GPS or connected external GPS.

Yes No

This equipment is type approved under the provisions of V/19-1.

Yes No

This is a GMDSS terminal and therefore it is type approved under the provisions of IV/14.

Yes No

This equipment is compliant with the requirements of IEC 60945 (2002-8) and IEC 60945 (2008-04).

Yes No

This is the Ship Security Alert System (SSAS) and therefore complies with provisions of regulation XI-2/6 and resolution MSC.

Yes No

To the best of my knowledge the information I have given is accurate. This information will be used to create the Conformance Test Report. Any mistakes that later invalidate the Conformance Test Report may incur additional charges to reissue the Conformance Test Report.

Agree

Other Information

Requested Testing Date (Month/Date/year)

Comment

Delivery Method

HRASSA arranged courier Post/CustomerArranged Courier