EPIRB registration

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

Official 406 MHz EPIRB Registration Form

Mail or Fax to:
NOAAlSARSAT
NSOF, E/SP3
4231 Suitland Road
Suitland, MD 20746
Fax No. 301-817-4565

EPIRB Information
Beacon ID (Unique Identifier Number)

Checksum

ITIIIJ ITIIIJ ITIIIJ

ITIIIJ

Please affix beacon manufacturer's label here.

EPIRB Manufacturer

(15 digit character ID provided by EPIRB manufacturer)

o Category I (Automatic Deployment)
o Category II (Manual Deployment)

Model No.

Purpose of EPIRB Registration

o New Registration
o Renewal of Registration
o Change of Ownership

o Replacement of Decal Only

o Change of Registration Information
o Replacement for a previously registered EPIRB
Please enter the old unique ID number

crcrn ITIIIJ ITIIIJ

Owner/Operator Information
Telephone

Name
(Last, First, Middle Initial)

(

Mailing Address

o
o
o
o

)

Area Code

(

)

Area Code

City

State/Province

ZIP (Postal) Code

Country

(

)

Area Code

(

)

Area Code

Home OWork OCeliular

0

Fax

0 Other

Home OWork OCeliular

0

Fax

0 Other

Home OWor!< OCeliular

0

Fax

0 Other

Home OWork OCeliular

0

Fax

0 Other

E-mail

Vessel Information
Usage:

o
o

Commercial
Government Military

Radio Equipment (Check all that apply)

o
o

Non-commercial

OVHF

Government Non-military

Power:

0

o

Fishing

OTug

0

o

HF

o

SSB

o

Other

Radio Call Sign

o

Cargo

OTanker

o

Pleasure Craft

Cellular

MMSI Number

INMARSAT

Other

Non-power:

OMF

Vessel Telephone Numbers

Type
Sail: Number of Masts

Life Boat

o

Life Raft

0

Federal I State Registration Number

Other

Vessel Name

Length Overall (tt)

Vessel Color

Homeport

Capacity
Crew and Passengers
MarinalDock

Survival Cratt(s) on Vessel: Life Boat - - Life Raft - No. of

No. of

Is your EPIRB equipped with a Simplified Voyage
Data Recorder (SVDR)? 0 Yes 0 No

City

State

Additional Data

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

(

)

Area Code

(

)

Area Code

(

)

Area Code

(

)

Area Code

Signature

o
o
o
o

Home
Home
Home
Home

o
o
o
o

Work OCellularO Fax

0 Other

Work OCellularO Fax

0 Other

Work OCellularO Fax

0 Other

Work OCellularO Fax

0 Other

(

)

Area Code

(

)

Area Code

(

)

(

)

Area Code
Area Code

o
o
o
o

Home OWork OCeliularO Fax

0 Other

Home OWork OCeliularO Fax

0 Other

Home OWork OCeliularO Fax

0 Other

Home OWork OCeliularO Fax

0 Other

Date

If you have any questions about thiS form or with EPIRB registration In general, please call1-888-212-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 Auth. (0648-0295) Expires. 30JUN2011
Rev. 05/2010

Important Notice - Please Read Before Completing Registration
Registration is an important facet for all Cospas-Sarsat 406 MHz emergency beacons. Not only is it required by Federal
Regulations but the information you furnish is used by Search And Rescue (SAR) agencies in the event of beacon
activation. The registration information is an important tool to assist the United States Coast Guard, United States Air
Force, and other SAR agencies in locating and quickly responding to you, your vessel, or your aircraft. Failure to register
your beacon may delay a rescue response. Accurate, up-to-date registration information will also be used to conserve
resources by helping to eliminate false alert deployments, as an inadvertent activation can be resolved with a phone call.
There is no charge for beacon registration. 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 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
to be affixed to the beacon and should be placed in such a way that it is clearly visible. 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.
Failure to register, re-register (as required every two years), or to notify NOAA of any changes to the status of your
406 MHz beacon could result in penalties and/or fines being issued under Federal Law. The owner or user of the 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 the 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) and
the U.S. Office of Management & Budget (OMB) Control Number: 0648-0295. 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 if your registration is outdated and credible
information is provided from other sources. NOAA will also seek information from other databases to update and/or
complement the existing information for an expired beacon registration. Although the information provided will become a
matter of public record, there is no intent to circulate beyond its intended purpose, i.e., to assist SAR agencies in carrying
out their 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, and completing and reviewing
the collection of information. Comments regarding this burden 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 remain a chief concern for SAR agencies. We ask that you carefully refer to the beacon’s user manual
for instructions on properly operating, installing, testing, performing required maintenance, and/or stowage of your beacon.
We find that these are important factors in reducing the number of false alerts. Please use the utmost care at all times!