Ship Security Alert System Registration

Save Time! Register your beacon online at: www.beaconregistration.noaa.gov

Mail or Fax to:

Official 406 MHz Ship Security Alert System
(SSAS) Beacon Registration Form

Fax No. 301-817-4565

SSAS Information

NOAA/SARSAT
NSOF, E/SP3
4231 Suitland Road
Suitland, MD 20746

Beacon ID (Unique Identifier Number)
(15 digit character ID provided by SSAS manufacturer)

SSAS Manufacturer __________________________________

Model No. _______________________________________

SSAS Registration
New SSAS Registration
Renewal of SSAS Registration
Change of SSAS Information or Ownership

Replacement of SSAS Decal
Check here if this SSAS is a replacement for a previously registered SSAS.
Please enter the old SSAS unique ID number ________________________

Owner/Operator Information
Name______________________________________________ Telephone
(Last, First, Middle Initial)

Mailing Address ______________________________________

(

)_____________________

Area Code

Home

Work

Cellular

Fax

Other

(

)_____________________

Home

Work

Cellular

Fax

Other

(

)_____________________

Home

Work

Cellular

Fax

Other

ZIP (Postal) Code __________ Country ___________________ (

)_____________________

Home

Work

Cellular

Fax

Other

___________________________________________________
City _____________________ State/Province _____________

Area Code
Area Code
Area Code

E-mail ______________________________________________

Vessel Information

Radio Equipment (Check all that apply)

Usage
Commercial
Government Military

VHF

Non-commercial
Government Non-military

Type
Sail: Number of Masts ____________________
Power:

Fishing

Tug

Cargo

Tanker

Pleasure Craft

Other ____________________

Non-power:

Life Boat

Life Raft

HF

SSB

Other __________________

Length Overall (ft) ____________Capacity _____________
Other__________________

Vessel Name _____________________________________
Vessel Color______________________________________

Crew and Passengers

Homeport ________________________________________
Marina/Dock

________________________ ________________________
City

State

Additional Data ___________________________________

Survival Craft(s) on Vessel
Life Boat ____________________

MF

Vessel Telephone Numbers
Radio Call Sign ___________ INMARSAT _____________
Cellular ________________ MMSI Number ____________
Federal or State Registration Number ________________

Life Raft ____________________

No. of

Additional Data
_________________________________________________

No. of

Emergency Contact Information (Please indicate someone other than the owner)
Name of Primary 24-Hour Emergency Contact:
__________________________________________________

Name of Alternate 24-Hour Emergency Contact:
________________________________________________

Telephone

Telephone

(

)_____________________

Home

Work

Cellular

Fax

Other

(

)_____________________

Home

Work

Cellular

Fax

Other

(

)_____________________

Home

Work

Cellular

Fax

Other

(

)_____________________

Home

Work

Cellular

Fax

Other

Area Code
Area Code
Area Code
Area Code

Signature __________________________________________

(

)_____________________

Home

Work

Cellular

Fax

Other

(

)_____________________

Home

Work

Cellular

Fax

Other

(

)_____________________

Home

Work

Cellular

Fax

Other

(

)_____________________

Home

Work

Cellular

Fax

Other

Area Code
Area Code
Area Code
Area Code

Date ____________________________________________

If you have any questions about this form or with SSAS registration in general, please call 1-888-212-SAVE (7283) or 301-817-4515.
For information on the U.S. Search & Rescue Satellite-Aided Tracking system, please visit: www.sarsat.noaa.gov

OMB (0648-0295) Expires: 31JAN2008

Important Notice - Please Read Before Completing Registration
Registration is an important facet for all Cospas-Sarsat 406 MHz Ship Security Alerting System (SSAS) beacons. Not
only is it required under Federal Regulations but the information you furnish is used by the United States Coast Guard in
the event of beacon activation. The registration information is an important tool to assist the Coast Guard in locating and
responding to your vessel. Failure to register your SSAS beacon may delay a timely response.
There is no charge for registering an SSAS beacon. This is a service provided by the U.S. National Oceanic and
Atmospheric Administration (NOAA).
All online registrations will be entered into the National 406 MHz Beacon Registration Database on the same day of entry.
Registration forms received via postal mail service will be entered within 2 business days of receipt. For online
registrations, a confirmation letter with your completed registration information form will be sent immediately via e-mail or
fax (if provided). Confirmation letters sent via postal mail should arrive within two weeks. Once your registration
confirmation is received, please review all information. Any changes or updates to your registration information can be
done via the internet, fax, e-mail or postal mail. If you do not receive your registration confirmation from NOAA on the
same day you submit it over the internet or within two weeks if you submit it by postal mail, please call NOAA toll-free at:
1-888-212-SAVE (7283) or 301-817-4515 for assistance.
After initial registration (or re-registration) you will receive a NOAA Proof of Registration Decal by postal mail. This decal
is not to be affixed to the SSAS beacon. Instead, the decal is required to be maintained in the SSAS Annex to the Vessel
Security Plan. For those vessels not required to maintain a Vessel Security Plan, please keep the decal on board along
with your vessel's registration documentation. If for some reason you do not receive the registration decal within two
weeks, please call NOAA toll-free at: 1-888-212-SAVE (7283) or 301-817-4515 for assistance.
Failure to register, re-register (as required every two years), or to notify NOAA of any changes to the status of your SSAS
beacon could result in penalties and/or fines being issued. The owner or user of the SSAS beacon is required to notify
NOAA of any changes to the registration information at any time. By submitting this registration the owner, operator, or
legally authorized agent declares under penalty of law that all information in this registration information is true, accurate,
and complete. Providing information that is knowingly false or inaccurate may be punishable under Federal Statutes.
Solicitation of this information is authorized by Title 47, Part 80 of the U.S. Code of Federal Regulations (CFR).
Additional registration forms can be found on the NOAA-SARSAT website at: www.sarsat.noaa.gov or at:
www.beaconregistration.noaa.gov.
Please note, NOAA will complement or update your registration information accordingly if your registration has expired
and credible information is provided from the Coast Guard. NOAA will also seek information from other databases to
update and/or complement the existing information for an expired SSAS registration.
Although the information provided will become a matter of public record, there is no intent to circulate the data furnished
beyond its intended purpose, i.e., to assist the Coast Guard in carrying out its mission. Public reporting burden for the
collection of this information is estimated to average 15 minutes per response, including the time for reviewing
instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing
the collection of information. Notwithstanding any other provisions of the law, no person is required to respond to, nor shall any
person be subjected to a penalty for failure to comply with, a collection of information subject to the requirements of the
Paperwork Reduction Act, unless that collection of information displays a currently valid OMB Control Number. Comments
regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden
should be sent to:
NOAA/SARSAT
NSOF, E/SP3
4231 Suitland Road
Suitland, MD 20746
Or call: 1-888-212-SAVE (7283) or 301-817-4515
Finally, false alerts are a significant concern to NOAA and the Coast Guard. We ask that you carefully refer to the SSAS
beacon user manual for instructions on properly operating, installing, testing, and when performing required maintenance.
We find that these are important factors in reducing the number of false alerts. Please use the utmost care at all times!