Record No.
RECORD OF PASSENGER/CARGO SHIP SAFETY RADIO EQUIPMENT (GMDSS)
General Particulars
Name of Ship: ……………………..………. Flag/Port of Registry: …………………………….
IMO-No.: ……………………………..……. Call Sign: ………………………………..……….
Builder: ……………………………………. Date Keel laid: ……………………………..…….
Gross Tonnage: ……………………………. Type of ship1: ……………………………..…….
MMSI No. Radiotelex (NBDP) No. Ship Earth Station:
……………………………. ……………………………. Service Provider ID Number
(Type and Model)
…………………….. ………………………….
Ship Earth Station:
Service Provider ID Number
(Type and Model)
…………………….. ………………………….
Note : as applicable
Sea area in which vessel is certified to operate:
A1 A1+A2 A1+A2+A3 (Ship A1+A2+A3 A1+A2+A3+A4
Earth Station) (MF/HF)
Maintenance requirements (check all that apply):
Duplication of Shore-based maintenance At-sea maintenance
equipment
1 Sources of energy
1.1 Emergency source of electrical power available for (II-1/42, 43, IV/13):
36 hours (Passenger ships) 18 hours (Cargo ships)
1.2 Reserve source of electrical power available for (IV/13):
1 hour 6 hours
1.3 Battery (IV/13):
Type: Voltage: Capacity: Location:
………………… ………………… ………………… …………………
1.4 Automatic charger (IV/13):
Manufacturer and Type: ………………… Full charge current: …………………
1
Additionally, ITU symbols designating classes of ships may be inserted.
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Form No.: SRT GMDSS (Rev.9) Page 1 of 7
Record No.:
2. Radio installation - Basic equipment (IV/7 and 8, 9, 10 or 11)
Manufacturer Type Serial No.
2.1 VHF - DSC controller …………….. …….. …………………….
- DSC watch receiver …………….. …….. …………………….
- Transmitter/receiver …………….. …….. …………………….
2.2 MF - DSC controller …………….. …….. …………………….
- DSC watch receiver …………….. …….. …………………….
- Transmitter/receiver …………….. …….. …………………….
2.3 MF/ - DSC controller
…………….. …….. …………………….
HF
- DSC watch receiver …………….. …….. …………………….
- Transmitter/receiver …………….. …….. …………………….
- Direct-printing telegraphy …………….. …….. …………………….
2.4 Ship Earth Station (SES) (see Note 1)
Inmarsat-C Inmarsat-
Other: …… …………….. …….. …………………….
2.5 Secondary means of alerting (IV/8, 9, 10 or 11)
Manufacturer Type Serial No.
2.5.1 VHF - DSC controller …………….. …….. …………………….
- Transmitter/receiver …………….. …….. …………………….
2.5.2 MF - DSC controller …………….. …….. …………………….
- Transmitter/receiver …………….. …….. …………………….
2.5.3 MF/ - DSC controller
HF …………….. …….. …………………….
- Transmitter/receiver …………….. …….. …………………….
2.5.4 Ship Earth Station (SES) (see Note
1)
Inmarsat-C Inmarsat-
Other: …… …………….. …….. …………………….
2.5.5 Satellite EPIRB:
Cospas/Sarsat …………….. …….. …………………….
2.6. Radio installation – Duplicated equipment (IV/15, IMO Resolution A.702(17))
Manufacturer Type Serial No.
2.6.1 VHF - DSC controller …………….. …….. …………………….
- Transmitter/receiver …………….. …….. …………………….
2.6.2 MF - DSC controller …………….. …….. …………………….
- Transmitter/receiver …………….. …….. …………………….
2.6.3 MF/HF - DSC controller …………….. …….. …………………….
- Transmitter/receiver …………….. …….. …………………….
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Form No.: SRT GMDSS (Rev.9) Page 2 of 7
Record No.:
2.6.4 Ship Earth Station (SES) (see Note
1)
Inmarsat- Inmarsat-
C Other: …… …………….. …….. …………………….
2.7 Facilities for reception of Maritime Safety Information, MSI (IV/7.1.4, 7.1.5)
Manufacturer Type Serial No.
2.7.1 NAVTEX receiver (see Note 2) …………….. …….. …………………….
2.7.2 EGC receiver (see Note 3) …………….. …….. …………………….
2.7.3 HF direct-printing telegraphy
receiver …………….. …….. …………………….
2.8 Satellite EPIRB
Manufacturer Type Serial No.
2.8.1 Cospas/Sarsat
Number: …………….. …………….. …….. …………………….
Location: …………….. …………….. …….. …………………….
2.8.2 Hydrostatic release unit …………….. …….. …………………….
2.8.3 Satellite EPIRB described in 2.8.1 is used as secondary means of alerting, and has been installed
close to, or by remote activation from, the position from which the ship is normally steered.
2.8.4 When 2.8.3 is ‘not selected’
2nd Satellite EPIRB:
Cospas/Sarsat
Location: …………….. …………….. …….. …………………….
2.9 Search and rescue locating devices (See Section 5)
3 Additional requirements for passenger ships (IV/6.4, 6.5, 6.6, 7.2)
Yes No
3.1 Distress panel for initiating distress alert at conning position
3.2 Distress alarm panel for indicating received distress alert at conning position
3.3 3.1 and 3.2 substituted by location of all DSC encoder at conning position
3.4 Continuous and automatic provision of ship’s position to relevant radio
equipment
3.5 Satellite EPIRB of item 2.8 is used as secondary means of alerting
3.6 When 3.5 is ‘YES’ - Remote activation of satellite EPIRB of item 2.8
Manufacturer: Type: Serial No.
3.7 When 3.6 is ‘NO’ -
2nd Satellite EPIRB:
Cospas/Sarsat …………….. …….. …………………….
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Form No.: SRT GMDSS (Rev.9) Page 3 of 7
Record No.:
3.8 Two-way radiotelephone apparatus
for aeronautical frequencies (121.5
MHz and 123.1 MHz) …………….. …….. …………………….
4 Position updating (IV/18, V/[Link])
Manufacturer Type Serial No.
4.1 Receiver (GNSS) …………….. …….. …………………….
4.2 Receiver (GNSS) …………….. …….. …………………….
4.3 Receiver (GNSS) …………….. …….. …………………….
5. Radio life-saving appliances (III/6.2.2 and 26.2.5)
5.1 Search and rescue locating devices
Manufacturer Type Serial No.
5.1.1 9 GHz radar transponder
Number 1:
Location: …………….. …….. …………………….
Number 2:
Location: …………….. …….. …………………….
5.1.2 AIS search and rescue transmitter
Number 1:
Location: …………….. …….. …………………….
Number 2:
Location: …………….. …….. …………………….
5.2 Two-way VHF radiotelephone
Number 1:
Location: …………….. …….. …………………….
Number 2:
Location: …………….. …….. …………………….
Number 3:
Location: …………….. …….. …………………….
6. Additional radio equipment required by Flag State, if any
No. Manufacturer Type Serial no. Reserve
Source
6.1 …………….. …………….. …….. ……………..
6.2 …………….. …………….. …….. ……………..
6.3 …………….. …………….. …….. ……………..
6.4 …………….. …………….. …….. ……………..
6.5 …………….. …………….. …….. ……………..
6.6 …………….. …………….. …….. ……………..
6.7 …………….. …………….. …….. ……………..
6.8 …………….. …………….. …….. ……………..
6.9 …………….. …………….. …….. ……………..
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Form No.: SRT GMDSS (Rev.9) Page 4 of 7
Record No.:
7. Additional Requirement for the Vessels Operating in Polar Waters
7.1 Sound Signal
Manufacturer Type Serial No.
Location: …………………
…………….. …….. …………………….
…………….. …….. …………………….
7.2 Two Way Voice Data Communication for Aeronautical frequency and Telemedical Assistance
Service (TMAS)
Manufacturer Type Serial No.
Location: …………………
…………….. …….. …………………….
…………….. …….. …………………….
7.3 Equipment for each Rescue Boat and Life Boat Released for Evacuation in Low Air
Temperature:
Manufacturer Type Serial No.
7.3.1 EPIRB (for Ship to Shore Distress
Alert)
Location: …………………
…………….. …….. …………………….
…………….. …….. …………………….
7.3.2 Survival Craft Radar Transponder /
AIS – SART (for Transmitting
Location Position)
Location: …………………
…………….. …….. …………………….
…………….. …….. …………………….
7.3.3 Two Way VHF Radio Telephone
apparatus operating on Channel 16
& other Channels (for On Scene
Communications)
Location: …………………
…………….. …….. …………………….
…………….. …….. …………………….
7.4 Vessel operating in Low Air Temperature; Each Survival Craft to be provided with:
Manufacturer Type Serial No.
7.4.1 SART / AIS SART (for
Transmitting Location Position)
Location: …………………
…………….. …….. …………………….
…………….. …….. …………………….
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Form No.: SRT GMDSS (Rev.9) Page 5 of 7
Record No.:
7.4.2 Two Way Radio Telephone
Apparatus (for On Scene
Communications)
Location: …………………
…………….. …….. …………………….
…………….. …….. …………………….
8 Remarks
The information contained in this record is a correct description of the Radio Equipment on board.
Name of Surveyor: __________________________ Name of Radio Inspector: ____________________
Signature of Surveyor: _______________________ Signature of Radio Inspector: _________________
Radio Company: ___________________________
Official Seal Official Seal
Date: _____________________
Port: _____________________
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Note 1 - Ship earth station (other than Inmarsat-C) which forms part of the GMDSS must conform to the Performance Standard as
follows:
1. If designed to operate in a mobile satellite service recognized on or after 1 January 2021, complies with the relevant
requirements of resolution A.1001 (25) and conforms to performance standards not inferior to those specified in the Annex
to Resolution MSC.434 (98).
2. If designed to operate in a mobile satellite service recognized before 1 January 2021:
a. Conforms to the relevant requirements of resolution A.1001 (25) and conforms to performance standards not inferior to
those specified in the Annex to Resolution MSC.434 (98).
OR
b. Conforms to the performance standards not inferior to those specified in the annex to:
i. Resolution MSC.130 (75) on Performance standards for Inmarsat Ship Earth Stations capable of two-way
communications, if installed after 1 February 1999.
ii. Resolution A.808(19) on Performance standards for Ship Earth Stations capable of two-way communications, if
installed on or after 23 November 1996 and before 1 February 1999;
iii. Resolution A.698 (17) on Performance standards for Ship Earth Stations capable of two-way communications, if
installed before 23 November 1996.
Note 2 - Navtex receiver equipment installed on or after 1 July 2019 must conforms to performance standards not inferior to those set
out in the annex to resolution A.148 (77), as amended by the annex to resolution MSC.430 (98).
Note 3 - EGC equipment installed on or after 1 July 2019 must conforms to the performance standards not inferior to those set out in
the annex to resolution MSC.306 (87), as amended by the annex to resolution MSC.431 (98).
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Form No.: SRT GMDSS (Rev.9) Page 6 of 7
Record No.:
9 Equipment renewals, alterations and/or additions effected since the record was prepared
Item Number
9.1 Port ……………….. Date …………..
Signature ___________________________
(………………………. )
Official Seal Name of Surveyor
9.2 Port ……………….. Date …………..
Signature ___________________________
(………………………. )
Official Seal Name of Surveyor
9.3 Port ……………….. Date …………..
Signature ___________________________
(………………………. )
Official Seal Name of Surveyor
9.4 Port ……………….. Date …………..
Signature ___________________________
(………………………. )
Name of Surveyor
Official Seal
9.5 Port ……………….. Date …………..
Signature ___________________________
(………………………. )
Name of Surveyor
Official Seal
9.6 Port ……………….. Date …………..
Signature ____________________________
(………………………. )
Official Seal Name of Surveyor
9.7 Port ……………….. Date …………..
Signature ____________________________
(………………………. )
Official Seal
Name of Surveyor
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Form No.: SRT GMDSS (Rev.9) Page 7 of 7