READ BEFORE COMPLETING FORM
INSTRUCTIONS FOR COMPLETING FORM CG-1258
A. VESSEL NAME: Insert name by which you wish the vessel to be known. If applying to change the vessel's name, insert the old vessel name in
parenthesis. Only standard Alpha and Numeric Characters in the vessel name will appear on the Certificate of Documentation. Click icon for
attachment if application covers multiple vessels.
B. OFFICIAL NUMBER: Insert the Official Number (O/N) awarded by the Coast Guard for all but Initial Issue cases.
C. HULL ID #: Insert Hull Identification Number (HIN) as assigned in accordance with 33 CFR 81.
D. IMO #: Insert International Maritime Organization Number (IMO), if any.
E. HAILING PORT: Insert name of place and state exactly as it is or will be marked on the vessel. The hailing port must be a place in the United
States. Commonly used abbreviations such as ‘NY, NY’ are acceptable.
F. MANAGING OWNER: Legal name, e-mail address and telephone number of the owner to whom the Coast Guard should send correspondence
and their Social Security Number (SSN) or Tax Identification Number (TIN). SSN or TIN IS REQUIRED. Only an owner or part owner can be the
managing owner. For vessels owned by a corporation the corporation is the managing owner. For a trust arrangement, the trustee is the managing
owner. For a Partnership or a LLC, the name of the Partnership or the LLC should be shown.
G. ADDRESS OF MANAGING OWNER: Enter the mailing address. If physical (street) address differs from mailing address, enter BOTH.
H. NAME(S) AND SOCIAL SECURITY NUMBER(S) OR TAX I.D. NUMBER(S) OF OTHER OWNERS: All persons/entities (other than managing
owner) who own an interest in the vessel. If no owners other than the managing owner, leave blank. Click icon for attachment if application covers
multiple owners.
I. PURPOSE OF APPLICATION: Check applicable blocks to show purpose of application. If vessel has never been documented, check Block #5
and provide ALL requested information known about the vessel's place and year of build, hull material, approximate length and previous names and
numbers. If this information is unknown, please indicate.
J. ENDORSEMENTS: Check the appropriate block(s) to indicate all endorsement(s) sought on this application.
K. PRIMARY SERVICE & HORSEPOWER: Select only ONE service for which the vessel will be primarily used and insert horsepower.
L. CITIZENSHIP: Vessel must be owned by a U.S. citizen eligible for the endorsement(s) sought. Select the section that describes the type of entity
that owns the vessel. Citizenship for all owners must be provided. See 46 CFR Subpart C for Citizenship Requirements.
INDIVIDUAL: Includes native born and naturalized U.S. citizens.
GOVERNMENT ENTITY: Includes Federal, State, Territory, Possession or Subdivision.
CORPORATION: Complete all items 1 thru 6.
LIMITED LIABILITY COMPANY (LLC): Complete Equity Section and choose type. For member managed LLC, a list of members is required. Click
icon for attachment if application covers multiple members.
PARTNERSHIP: Complete Equity Section and choose type. A list of all general partners is required. Click icon for attachment if application covers
multiple general partners.
CORPORATIONS QUALIFIED UNDER 46 CFR 68.01 OR OWNED BY A NOT-FOR-PROFIT OIL RECOVERY COOPERATIVE:
Attach a copy of the Certificate of Compliance or Letter of Qualification issued by the Director, NVDC.
JOINT VENTURE/ASSOCIATION: A list of all joint venturers/members is required. The percentage held by each need not be shown. Click icon for
attachment if application covers multiple joint venturers/members.
TRUST ARRANGEMENT: All trustees must be U.S. citizens. If applicable, each beneficiary with an enforceable interest must be a citizen. A list of
all trustees (except managing owner) and beneficiaries with an enforceable interest is required. Click icon for attachment if application covers
multiple trustees/beneficiaries with an enforceable interest.
M. CERTIFICATION: Complete as appropriate. The law provides severe penalties for false statements against both the person (including agents)
making the statement and against the vessel for which it is made.
NOTE: When applying for Fishery and/or Coastwise endorsement(s), see item 5.
CG-1258 (0 Page 1 of 4
READ THE PRIVACY ACT STATEMENT AT THE END OF THE CG-1258.
ADDITIONAL INFORMATION ABOUT DOCUMENTATION MAY BE FOUND AT OUR WEBSITE
www.uscg.mil/nvdc and in 46 CFR Parts 67, 68 and 69.
YOU MAY ALSO CONTACT OUR OFFICE AT: 800-799-8362 OR BY MAIL AT U. S. COAST GUARD,
NATIONAL VESSEL DOCUMENTATION CENTER, 792 TJ JACKSON DRIVE, FALLING WATERS, WV 25419.