Source document: https://docs-lawep.s3.us-east-2.amazonaws.com/1694499464505.pdf (Antigua and Barbuda)
APPLICATION FOR A MINIMUM SAFE MANNING DOCUMENT This form should be completed by any owner or manager on applying for a Minimum Safe Manning Document as required by Regulation 14 of Chapter V of SOLAS.

In completing the application owners and managers should take account of the Principles in IMO Resolution A.1047 (20th December 2011) “Principles of Safe Manning” and also the requirements on hours of rest contained in ILO Convention 180, the STCW Convention and the Maritime Labour Convention.
Applicants are asked to provide as much detail as necessary in order that ADOMS may quickly agree the level of manning.

Ship’s name IMO No.

Ship Type Gross Tonnage Engine Power (kW) Expected trading pattern Year of Build Length UMS (Yes/No) No.

of lifeboats Type of boats, Special features E.g., DP operations, self unloading, etc.

Are crew members require to operate ship’s equipment for cargo operations?

If yes, give details.


Are ship’s crew members required to undertake any tasks associated with care for cargo, cargo securing, cargo security etc while at sea?

If Yes, give details.


FO_T29 – Revision 2 - 11.12.13 Application for a Minimum Safe Manning Document Page 1 of 4 APPLICATION FOR A MINIMUM SAFE MANNING DOCUMENT Additional information In the following table, applicants are invited to enter the proposed numbers for the ship’s manning based on their assessment of the requirements and the principles in A.1047.

No.

Main duties.
Planned working hours schedule Master 1 Chief mate Navigational Watchkeeping Officer Chief Engineer Second Engineer Engineering Watchkeeping Officer Electro technical Officer Deck ratings (Watch rating qualified) Other Deck Ratings FO_T29 – Revision 2 - 11.12.13 Application for a Minimum Safe Manning Document Page 2 of 4 APPLICATION FOR A MINIMUM SAFE MANNING DOCUMENT Engineering Ratings (Watch rating qualified) Other Engine Ratings Cargo engineer Cook Doctor Others Total Submitted by: Date submitted: Please attach any other supporting documentation that is necessary to support the application.
ADOMS will endeavour to respond within 10 days of receipt with a draft Safe Manning Document.

FO_T29 – Revision 2 - 11.12.13 Application for a Minimum Safe Manning Document Page 3 of 4 APPLICATION FOR A MINIMUM SAFE MANNING DOCUMENT This section is for the use of the officer assessing the submission.

References are to Section 3 of Annex 1 to A.1047(27) Yes No Sufficient personnel to: Maintain safe navigational, port, engineering and radio watches in accordance with Reg.
VIII/2 STCW and also maintain general surveillance of the ship.

3.1.1.1 Moor and unmoor the ship safely 3.1.1.2 Manage the safety functions of the ship when employed in a stationery or near-stationery mode at sea (if applicable) 3.1.1.3 Perform operations as appropriate for the prevention of damage to the marine environment.

3.1.1.4 Maintain the safety arrangements and the cleanliness of all accessible spaces to minimise the risk of fire.

3.1.1.5 Provide for medical care on board.


3.1.1.6 Ensure safe carriage of cargo during transit.

3.1.1.7 Inspect and maintain, as appropriate, the structural integrity of the ship.

3.1.1.8 Operate in accordance with the ship’s Security Plan.
3.1.1.9 Operate all watertight closing arrangements, maintain them, and deploy a competent damage control party, 3.1.2.1 Operate all on-board fire fighting and emergency equipment and life-saving appliances, carry out maintenance required to be done at sea, and muster and disembark persons on board, 3.1.2.2 Operate main propulsion and auxiliary machinery including pollution prevention equipment and maintain them in a safe condition.
3.1.2.3 Functions above can be carried out within the applicable limits on hours of rest.

There are sufficient personnel proposed to deploy an emergency party and to launch and operate the ship’s lifesaving appliances.

Manning proposal agreed.

Assessed by: .............................................................

Completed on: .................................................. FO_T29 – Revision 2 - 11.12.13 Application for a Minimum Safe Manning Document Page 4 of 4