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Government of Canada / Gouvernement du Canada

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Consent of Vessel Owner(s) for the Possession, Removal and Disposal of a Vessel by a Third Party

This form is for information purposes only. To fill out a copy of this form, please download the Word doc version.

 Download the owner consent form

This consent confirms the owner(s) agreement to have a third party take possession, remove and permanently dispose of their vessel, without compensation or indemnification.

1. Vessel information:

Vessel Registration Number:

Color:

Material:

Vessel name:

Licence number:

Location of the vessel:

Municipality/county/district:

Province/Territory:

2. Identification of owner(s)*

Name:

Name:

Address:

Address:

Telephone numbers (work/home/other):

Telephone numbers (work/home/other):

Email:

Email:

Name:

Name:

Address:

Address:

Telephone numbers (work/home/other):

Telephone numbers (work/home/other):

Email:

Email:

*This information must be provided for every owner

3. Pollutants on board the vessel, if any*:

Pollutant:

Approx. quantity:

Pollutant:

Approx. quantity:

Pollutant:

Approx. quantity:

*The owner(s) must list any pollutants remaining on board the vessel (including fuels) of which they are aware, and indicate approximate quantities for each.

4. Known potential challenges to the safe and effective permanent removal/disposal of the vessel:

*The owner(s) must describe any potential challenges to the safe and effective permanent removal of the vessel of which they are aware (ex: vessel is taking on water, hull is breached, vessel is situated in a treacherous area, vessel is involved in a legal dispute, etc.)

5. Attestation and consent*

I am/we are the lawful owner(s) / an officer of the owner(s) of the vessel duly authorized to sign this consent.

I/we certify that, to the best of my/our knowledge and belief, the information given herein is true, accurate and complete.

I/we hereby grant (name of third party), for that third party's own benefit, irrevocable authorization to permanently remove and dispose of the vessel (including anything left on board), such authorization being granted freely and without compensation or indemnity.

I/we hereby relinquish and abandon all rights to the vessel.

Name of owner:

Name of owner:

Signature:

Signature:

Date:

Date:

Name of owner:

Name of owner:

Signature:

Signature:

Date:

Date:

*All vessel owner(s) must sign the attestation and consent.

The authorization is requested because it is considered that the vessel impedes, interferes with or render difficult or dangerous the use of the harbour. The personal information provided on this form is therefore collected under the authority of the Fishing and Recreational Harbours Act. This information is required for the purpose of identifying the owner of the vessel before authorizing an interested party to take possession of and remove the vessel, part of the vessel or thing for that person's own benefit. Under the provisions of the Privacy Act, individuals have the right of access to, correction of and protection of their personal information. Instructions for obtaining personal information are provided in Info Source, a copy of which is available in major public and academic libraries or online at http://www.infosource.gc.ca.

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