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Vessel Static Data Form

To comply with FCC regulations, Class B AIS units shipped to customers in the USA must be pre-programmed with the vessel's information by Milltech Marine. We offer this service free of charge.

Warning: It is a violation of the rules of the Federal Communications Commission to provide or program an MMSI that has not been properly assigned to the end user, or to otherwise provide inaccurate vessel information.
Please enter all information requested below
Vessel Owner Name:
MMSI Registered To:
Milltech Marine Order Number:
Order Comments:

TYPE OF MMSI
Comments
FCC Ship Station License with MMSI and Call Sign. Required for US vessels that sail internationally
MMSI Registration from Boat US, US Power Squadron, or Other. Acceptable for US vessels on US domestic
voyages only
Non-US vessels: The MMSI is issued by your ship registry or telecommunications authority.
Proof of valid MMSI is required for all non-FCC issued MMSI numbers. Please select the button above for your type of MMSI and submit a copy of issuing document via email or fax 425-484-6218

VESSEL INFORMATION
Enter the following information.
MMSI number (9 digits):
Vessel Name (20 characters):
Call Sign (If applicable):
Length of vessel in feet:
Beam of vessel in feet:

Determine position of GPS antenna on vessel. Round distance to nearest meter (3.3 feet)
(A) Distance from bow to the GPS antenna
meters
(B) Distance from stern to the GPS antenna meters
(C) Distance from the port side to the GPS antenna
meters
(D) Distance from the starboard side to the GPS antenna
meters

Type of Vessel and record

As vessel owner or captain, I certify that the above vessel identification information is correct and valid:
Name:
Date: