Service Contract Registration (Federal Maritime Commission)
This is a Federal Maritime Commission service contract registration (United States). The form provided here is simply a sample of what the actual Form FMC-83 looks like.
Service Contract Registration (Federal Maritime Commission)
This is a Federal Maritime Commission service contract registration (United States). The form provided here is simply a sample of what the actual Form FMC-83 looks like.
ORGANIZATION NO. ___________________
PLEASE TYPE OR PRINT
SERVICE CONTRACT REGISTRATION
(SEE ATTACHED INSTRUCTIONS)
1. Organization Number _________________________
2. Registrant Type (Check all that applies)
[___] VOCC
[___] Tariff Publisher/Agent/Other
[___] Agreement
[___] Conference/Joint Service
3. Registrant
_________________________ Full Legal Name of firm (or individual, if not a firm)
_________________________ (Doing Business As)
4. This Registration is:
[___] Initial
[___] Amendment (Specify change)
[___] Dial-up
[___] Internet-based
5. Address of Home Office (Please record any changes)
_________________________ (Number and Street)
Telephone (_____)_________________________
_________________________ (Number and Street)
Fax (_____)_________________________
_________________________ (City/State/Country)
_________________________ (Federal TIN Number)
_________________________ E-Mail (optional)
6. Billing Address If Different
_________________________ (Number and Street)
Telephone (_____)_________________________
_________________________ (Number and Street)
Fax (_____)_________________________
_________________________ (City/State/Country)
_________________________ E-Mail (optional)
7. Permissions Requested and Person granted these permissions: For the Internet-based system, please list individual(s) who will need logons. If the individual is a publisher, a letter of authority must be submitted.
_________________________ Full Legal Name
If this is transfer of logon, please list for each the Existing Log-on
_________________________
____ File Service Contracts
_________________________ Signature of Authorized Official
_________________________ Print or Type name of Authorized Official
_________________________ date
FMC USE ONLY
Logon __________________
Initial Password __________________
ID ___________________
Directory __________________
Date Asg _____/_____/_____
Asg By ___________________________
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INSTRUCTIONS FOR FILLING OUT THIS FORM
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Line 1. Organization Number: Complete if known. (Regulated Persons Index or "RPI" number.)
Line 2. Registrant Type: Indicate the type of organization. Please check all that applies.
Line 3. Registrant: This must be the full name of the firm or individual registering for the FMC's Service Contract Filing System and any trade names. The registrant name should match the corporate charter or business license, conference membership, etc. It should be noted that the registrant name cannot be changed by the registrant after the registration without submission of an amended registration form.
Line 4. Registration: Indicate whether this is the initial (first time) registration or an amendment to an existing Service Contract Registration.
Line 5. Address of Home office: The complete street address should be shown in addition to the post office box. Also, provide the registrant's Federal Taxpayer Identification Number ("TIN" Number).
Line 6. Billing Address if Different: This should be completed if the billing address differs from the home office address. Show the firm name (if different from the registrant), street address and post office box (if applicable).
Line 7. Permissions Requested and Person Granted These Permissions: Delegation of the authority to file should be noted here. The person listed in line 7 is authorized only to submit filings.