Pref. Ship Mortgage Signature by or on behalf of the vessel owner(s) and acknowledged by a notary public Addresses of both the mortgagor and mortgagee Must cover the “whole” of the vessel; cite a definite amount, identify the vessel by name, official number and/or hull number A mortgage cannot be accepted for filing unless the vessel has a valid Certificate of Documentation or an Application for Initial, Exchange or Replacement, CG-1258, on file at the NVDC. 1. VESSEL NAME AND OFFICIAL NUMBER (OR OTHER UNIQUE IDENTIFIER)LIST COAST GUARD ASSIGNED OFFICIAL NUMBER, MANUFACTURER’S HULL IDENTIFICATION NUMBER (HIN) ASSIGNED IN ACCORDANCE WITH RULES IN 33 CFR, OR OTHER UNIQUE IDENTIFIER, (STATE MOTORBOAT NUMBERS ARE NOT CONSIDERED UNIQUE IDENTIFIERS.)2. INSTRUMENT TYPE (CHECK ALL THAT APPLY) PREFERRED MORTGAGE CHATTEL MORTGAGE AMENDMENT SUPPLEMENT SUBORDINATION ASSIGNMENT OTHER Describe3. NAME(S) AND ADDRESS(ES) OF GRANTOR(S) (MORTGAGOR(S), ASSIGNOR(S), ASSUMING PARTY(IES), OR OTHER(S)GRANTOR. FOR PURPOSES OF THIS FORM, GRANTORS INCLUDE MORTGAGORS, ASSIGNORS, PERSONS ASSUMING MORTGAGES, PERSONS GRANTING SUBORDINATION OF MORTGAGES. LIST ALL GRANTORS AND ADDRESSES. INTEREST OWNED IN VESSEL OR HELD IN MORTGAGE AFFECTED BY ATTACHED INSTRUMENT (100% UNLESS OTHERWISE STATED)4. NAME(S) AND ADDRESS(ES) OF GRANTEE(S) (MORTGAGEE(S), ASSIGNEE(S), OR OTHER(S)GRANTEE. FOR PURPOSES OF THIS FORM, GRANTEES INCLUDE MORTGAGEES, ASSIGNEES, PERSON FROM WHOM MORTGAGES ARE ASSUMED, AND PERSON TO WHOM SUBORDINATION OF MORTGAGES ARE GRANTED. LIST ALL GRANTEES AND ADDRESSES.PERCENTAGE OF VESSEL MORTGAGED OR MORTGAGE ASSIGNED (100% UNLESS OTHERWISE STATED)5. AMOUNT6. IDENTIFICATION ON INSTRUMENT ASSUMED, ASSIGNED, AMENDED, SUPPLEMENTED, SUBORDINATED, OR, OTHERWISE MODIFIED: NOT USED FOR NEW CHATTEL OR PREFERRED MORTGAGES. MUST BE COMPLETED FOR ASSUMPTIONS, ASSIGNMENTS, AMENDMENTS, OR OTHER INSTRUMENTS MODIFYING CHATTEL OR PREFERRED MORTGAGE FILED PREVIOUSLY OR CONCURRENTLY.RECORDED BOOK:PageFILE/RECORDED DATE: TIME:OTHER IDENTIFYING DATA:Digital Signature of Owner or person acting for Owner*I (We) hereby certify that the facts recited herein are true and correct. I (We) understand that the U.S. Coast Guard will rely on those recitations in indexing the attached instrument.PREFERRED SHIP MORTGAGE Price: $165.00 Please select any additional services you wish to have processed Priority Request/Rush Processing Abstract of Title Certified copy of COD Satisfaction of Mortgage SATISFACTION OF MORTGAGEINSTRUMENT TYPE (CHECK ALL THAT APPLY) PREFERRED MORTGAGE CHATTEL MORTGAGE AMENDMENT ASSUMPTION SUPPLEMENT SUBORDINATION ASSIGNMENT OTHER (DESCRIBE) DescribeNAME(S) AND ADDRESS(ES) OF GRANTOR(S) (MORTGAGOR(S), ASSIGNOR(S), ASSUMING PARTY(IES), OR OTHER(S)GRANTOR. FOR PURPOSES OF THIS FORM, GRANTORS INCLUDE MORTGAGORS, ASSIGNORS, PERSONS ASSUMING MORTGAGES, PERSONS GRANTING SUBORDINATION OF MORTGAGES. LIST ALL GRANTORS AND ADDRESSES. INTEREST OWNED IN VESSEL OR HELD IN MORTGAGE AFFECTED BY ATTACHED INSTRUMENT (100% UNLESS OTHERWISE STATED)NAME(S) AND ADDRESS(ES) OF GRANTEE(S) (MORTGAGEE(S), ASSIGNEE(S), OR OTHER(S)GRANTEE. FOR PURPOSES OF THIS FORM, GRANTEES INCLUDE MORTGAGEES, ASSIGNEES, PERSON FROM WHOM MORTGAGES ARE ASSUMED, AND PERSON TO WHOM SUBORDINATION OF MORTGAGES ARE GRANTED. LIST ALL GRANTEES AND ADDRESSES.PERCENTAGE OF VESSEL MORTGAGED OR MORTGAGE ASSIGNED (100% UNLESS OTHERWISE STATED)AmountIF THE FOLLOWING INFORMATION IS UNKNOWN YOU MUST ORDER AN ABSTRACT OF TITLE UNDER ADDITIONAL SERVICES TOWARDS THE TOP OF THE PAGE. RECORDED BOOK:PageFILE/RECORDED DATE: TIME:OTHER IDENTIFYING DATA:USCG RENEWAL DOCUMENTATION ADVANCED PAYMENT OPTIONEliminate the possibility of late fees and reinstatement fees by paying your yearly renewal documentation in advance. Your certificate of documentation will be automatically renewed each year, per the number of years selected, by Vessel Documentation Online LLC. NOTE: The NVDC only issues their vessel renewals for a period/duration of one year each. Your yearly certificate will be valid for one year only. You will receive one (1) Year long certificate each year, depending on how many additional years you have ordered. For each individual year of renewal a new renewal will be AUTOMATICALLY forwarded to your designated address at time of renewal(s). This may require that the vessel owner update their current address to facilitate the renewal process. 1 year renewal (additional $70.00) 2 year renewal (additional $140.00) 3 year renewal (additional $210.00) 4 year renewal (additional $280.00) 5 year renewal (additional $350.00) Total $0.00 Signature*Authorization* I agree to pay the above total amount according to the card issuer agreement and hereby authorize the charge for the total amount above for the processing of selected USCG documents. I understand that my application will be processed in the order in which it is received by Vessel Documentation Online LLC, a private fee for service documentation company, not owned or operated by any governmental agency. I understand that application and processing fees are non-refundable as per Vessel Documentation Online LLC's no refund policy and as per 46 CFR 67.500(e) PAYMENT INFORMATION* American ExpressDiscoverMasterCardVisa Card Number Month010203040506070809101112 Year20212022202320242025202620272028202920302031203220332034203520362037203820392040 Expiration Date Security Code Cardholder Name Having Trouble? 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By: wddevelopers | July 5, 2016
