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ITF 16 Point Consultation Questionnaire (Print Copy - Fill in the Form)
1 Present Flag, Date of Registry, Ship's Name, and Ship's IMO Number
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2 Type of Vessel
_________________________________________________________________________________________________
3 Previous Flag and Ship's Name
_________________________________________________________________________________________________
4 Date of Build
_________________________________________________________________________________________________
5 Gross Tonnage
_________________________________________________________________________________________________
6 Name and Address of Present Registered Owner
_________________________________________________________________________________________________
7 Name and Address of Previous Registered Owner
_________________________________________________________________________________________________
8 Name and Address and Profession of Present Individual (S) who is (are) Beneficial Owner (S)
_________________________________________________________________________________________________
9 Name and Address of Previous Beneficial Owner
_________________________________________________________________________________________________