Notice of Claim of Lien (NCL) NOTICE OF CLAIM OF LIEN (NCL) These are general instructions highlighting the minimum filing and recording requirements. There is no OMB approved Notice of Claim of Lien form. Guidance on the elements and validity of a maritime lien should be obtained through private legal counsel in accordance with 46 CFR Part 67.250.nDISCLAIMER: NEITHER THE FILING OF A NOTICE OF CLAIM OF LIEN NOR THE ACCEPTANCE BY THE COAST GUARD OF SUCH A NOTICE IS A GUARANTEE THAT THE CLAIM IS VALID OR ENFORCEABLE. VESSEL NAMEOFFICIAL NUMBERHULL ID NUMBER (HID) *IF APPLICABLEPLEASE SPECIFY NAME OF CLAIMANT (INDIVIDUALS/ENTITIES WHO ARE OWED MONEY) First Last PLEASE ENTER ADDRESS OF CLAIMANT (INDIVIDUALS/ENTITIES WHO ARE OWED MONEY) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSaint MartinSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country ENTER AMOUNT OF CLAIMDATE OF CLAIM PLEASE DESCRIBE THE NATURE OF LIEN CLAIMEDACKNOWLEDGMENT OF ACCURACY I DECLARE THE INFORMATION STATED ABOVE TO BE TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE, INFORMATION, AND BELIEF. NOTICE OF CLAIM OF LIEN( NCL) Price: $225.00 PLEASE SELECT ANY ADDITIONAL SERVICES YOU WISH TO ADD TO HAVE PROCESSED Priority Request/Rush Processing Abstract of Title Certified Copy of COD Priority Request/Rush Processing Price: $75.00 Abstract of Title Price: $75.00 Certified Copy of COD Price: $75.00 USCG RENEWAL DOCUMENTATION ADVANCED PAYMENT OPTIONYou can eliminate the possibility of late fees, as well as reinstatement fees, by paying your yearly renewal documentation in advance. Your certificate of documentation will be automatically renewed each year, for the number of years selected, by Maritime Documentation Center, a private documentation firm. NOTE: The NVDC only issues their vessel renewals for a period/duration of one year each. Your yearly certificate will be valid for one year only. You will receive one (1) Year long certificate each year, depending on how many additional years you have ordered. For each individual year of renewal a new renewal will be AUTOMATICALLY forwarded to your designated address at time of renewal(s). This may require that the vessel owner update their current address to facilitate the renewal process.No Additional Years1 year renewal (additional $75.00)2 year renewal (additional $150.00)3 year renewal (additional $225.00)4 year renewal (additional $300.00)5 year renewal (additional $375.00)Total $0.00 Signature*Authorization* I agree to pay the above total amount according to the card issuer agreement and hereby authorize the charge for the total amount above for the processing of selected USCG documents. I understand that my application will be processed in the order in which it is received by Maritime Documentation Center, a private fee for service documentation company, not owned or operated by any governmental agency. I understand that application and processing fees are non-refundable as per Maritime Documentation Center and as per 46 CFR 67.500(e) PAYMENT INFORMATION* American ExpressDiscoverMasterCardVisa Card Number Month010203040506070809101112 Year20192020202120222023202420252026202720282029203020312032203320342035203620372038 Expiration Date Security Code Cardholder Name Having Trouble? Check this box to move forward without your Credit Card *My card information is not working; I would like to continue my submission and receive a call from a specialist regarding payment YOUR BILLING ADDRESS* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSaint MartinSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country Your Name* First Last Email* Enter Email Confirm Email Phone*By clicking submit you agree to these Terms and Conditions and the above authorization of payment. By: Maritime Documentation Center | July 5, 2016