Form 131

FEDERAL MARITIME COMMISSION
BUREAU OF CERTIFICATION AND
LICENSING

APPLICATION FOR CERTIFICATE
OF FINANCIAL RESPONSIBILITY
(PERFORMANCE AND CASUALTY)

Approved OMB No.
(Expires XX-XX)

FMC-131 (Rev. X-XX)

INSTRUCTIONS
Submit the application to the Bureau of Certification and Licensing, Federal Maritime Commission, Washington, D.C. 20573, or
via email at pvo@fmc.gov. The application is in four parts: Part I – General; Part II – Vessels; Part III – Financial Responsibility and
Part IV - Declaration. Applicants must answer all questions in Part I , Parts II and Part III as appropriate. Instructions relating to
Part II and Part III are contained at the beginning of the respective part. If additional space is required, supplementary sheets may
be attached to this application.

PART I - GENERAL
1. (a) Legal name of applicant (name of responsible operator of all vessels listed

THIS SPACE FOR USE BY FMC ONLY

in Part II):

(b) Trade name, or names used:

2. (a) State applicant's legal form of organization associated with each vessel for which you are making application, i.e. whether
operating as an individual, corporation, partnership, association, or other organized group of persons (whether incorporated or
not), and briefly describe applicant's current business activities.

(b) If a corporation, association, or other organization, indicate:
State in the United States, or foreign country, in which incorporated or organized:

Date of incorporation or organization:

(Please include copy of Articles of Incorporation, Articles of Formation or Partnership Agreements.)

(c) If a partnership, provide name and address of each partner:

3. Name and address of applicant's United States agent or other person authorized by applicant to accept service of process
and receipt of notices of designations and presentations of claims in the United States (collectively referred to as "service of
process").

Federal Maritime Commission, BCL, FMC-131, Rev XX-XX

PART II - VESSEL(S)
4. APPLICATION TYPE:

A. ADDITION

B. REMOVAL

C. RENEW

5. VESSEL DETAILS:
Name

Country of

Registration

Maximum number of berth

of Vessel

Registry

No.

or stateroom accommodations

6. Provide name(s) of any other entity that may be arranging, offering, advertising or providing passage on a vessel or covering the
owner or charterer of the vessel. (eg. Owner, Ticket Issuer, Charterers, Marketing Agent, Technical Manager, Parent Company)

PART III - FINANCIAL RESPONSIBILITY
7. Submit itinerary and indicate whether it is for a single voyage, multiple voyages or all voyages scheduled annually.
8. (a) Submit a copy of the passenger ticket or other contract evidencing the sale of passenger transportation.
(b) Provide location of webpage containing refund policy under nonperformance of transportation within the meaning of 46 CFR Part 540.2.
9. SECTION 3 - (PERFORMANCE) Financial Responsibility Calculations (Example)
CABIN

NO OF

CATEGORIES

CABINS

OWNER Suite

X

Category AA

X

Category B

X

Category C

X

NO OF

COST PER

TOTAL

PASSENGERS PASSENGER COST

x
x
x
x

x
x
x
x
x

NO. OF

EST INITIAL

CRUISES

UPR

x
x
x
x
x

x

Calculate these figures for each itinerary then add the total for each itinerary to estimate your total unearned passenger revenue.

10. SECTION 2 - (CASUALTY) Financial Responsibility Calculations (Example)
Largest Number of Berth Accommodations:
Passenger Accommodations

Coverage for each

Calculation

accommodation

Cumulative
Total

Up to and including 500; plus

$20,000

$20000 * 500

Between 501 and 1000; plus

$15,000

15000 * 500

Between 1001 and 1500; plus

$10,000

10000 * 500

In excess of 1500

$5,000

5000 * 500+

Federal Maritime Commission, BCL, FMC-131, Rev. 2-20

Total

11. Evidence of financial responsibility may be submitted to the Commission using one of the below methods.
Check only the item(s) which are applicable to this application:
PERFORMANCE

CASUALTY

INSURANCE:
SURETY BOND:
GUARANTY:
ESCROW AGREEMENT:
FINANCIAL INSTRUMENT PROVIDER:
$ VALUE OF FINANCIAL INSTRUMENT:

PART IV - DECLARATION
12. Applicant's mailing address (street, number, post office box, city, state or country, indicate zip code if in the United States):

13. Telephone number (Area Code and Number)

14. E-mail address:

I declare that I have examined this application, including and accompanying schedules and statements, and, to the best of my
knowledge and belief, it is true, correct, and complete. Furthermore, the applicant named in item 1(a) of Part I above is the
responsible operator of all vessels now listed in or later added to this application. I agree that the agent designated in item 4 of
Part I above, or that agent's replacement as may be designated later with the approval of the Secretary, Federal Maritime Commission,
is considered the agent for service of process. I have signed this application in my capacity as an authorized official of the applicant,
or, if acting under a power of attorney, pursuant to the power vested in me by the applicant as evidenced by the attached power of
attorney.
SIGNATURE OF AUTHORIZED OFFICIAL:

Type or print name of Authorized Official:

NOTE: Please be sure Parts I, II, and III have been completed in full.

Federal Maritime Commission, BCL, FMC-131, Rev XX-XX

DATE: