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Steamship Agent/ Stevedore License Application

  1. Mailing Information
  2. Corporate Officer or Owner’s Information
  3. Business Information
  4. If Applicant Is an Individual...
  5. If Applicant Is a Firm...
  6. Banking Information
    Do not provide any confidential information on this form, such as account or routing numbers.
  7. Has Applicant ever had a bond or letter of credit called due to a claim of default?*
  8. Signature
    The applicant agrees that when this application is approved and a permit is granted to abide by all the rules and regulations of the Port of Palm Beach District and all the provisions of the Port of Palm Beach District Tariff, as amended periodically. The provisions of the Steamship Agency instructions and Stevedore instructions are incorporated herein, and by executing the application, the Applicant agrees to be bound thereby. Nothing contained herein shall relieve Applicant or its employees from the obligation to comply with security requirements now existing or hereinafter imposed by the Port of Palm Beach District, Local, State, and Federal Authorities.
  9. Leave This Blank:

  10. This field is not part of the form submission.