TÊN CÔNG TY ——– | CỘNG HÒA XÃ HỘI CHỦ NGHĨA VIỆT NAM Độc lập – Tự do – Hạnh phúc ————— |
Số:…………. | ………, ngày…. tháng…. năm 20….. |
ĐƠN ĐỀ
NGHỊ
Giao tuyến dẫn tàu hoa tiêu hàng hải
Kính gửi: Cục Hàng hải Việt Nam.
Tên công ty:…………………………………………………………………………………………….
Người đại diện theo pháp luật:……………………………………………………………………
Mã số đăng ký kinh doanh:
Địa chỉ:…………………………………………. Số điện thoại liên hệ:…………………………
Đề nghị Cục Hàng hải Việt Nam giao tuyến dẫn tàu hoa tiêu hàng hải dưới đây cho công ty……………………………….:
1. Tuyến dẫn tàu……………… thuộc vùng hoa tiêu bắt buộc…………………………….
2. Tuyến dẫn tàu……………… thuộc vùng hoa tiêu bắt buộc…………………………….
……………………………………………………………………………………………………………….
Văn bản kèm theo:
1. Danh sách hoa tiêu các hạng (kèm theo bản sao Giấy chứng nhận khả năng hoa tiêu hàng hải và bản sao Giấy chứng nhận vùng hoạt động hoa tiêu hàng hải của từng hoa tiêu).
2. Bản kê khai phương tiện đưa, đón hoa tiêu (kèm theo bản sao Giấy chứng nhận đăng ký của phương tiện đó).
Kính đề nghị Cục Hàng hải Việt Nam xem xét, quyết định./.
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