GOVERNMENT OF THE VIRGIN ISLANDS OF THE UNITED STATES DEPARTMENT OF PLANNING AND NATURAL RESOURCES DIVISION OF ENVIRONMENTAL ENFORCEMENT REQUEST FOR VESSEL INFORMATION All Blanks Must Be Filled In NAME: _____________________________________ TITLE: _________________________ AGENCY: __________________________________ CONTACT NO: ___________________ REGISTRATION/DOCUMENTED NO: __________________________________________ REQUESTED INFORMATION: _________________________________________________ REASON FOR REQUEST: _____________________________________________________ SIGNATURE: _____________________________________ DATE: ____________________ DO NOT WRITE BELOW THIS LINE VESSEL OWNER: ____________________________________________________________ REGISTRTION STATUS: Current Last Registration Date ______________________ INFORMATION PROVIDED: __________________________________________________ ______________________________________________________________________________ COMMENTS: ________________________________________________________________ OFFICE PERSONNEL: ________________________________ DATE: _________________