4) , Browns Nautical Almanac
| 29 (1) | |||
| / CERTIFICATE OF SEAGOING SERVICE
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| /Name of Company | |||
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| /Address and Contact Details _______________________________________ | |||
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| /Tel. / Fax: e-mail | |||
| : / This is to certify that: | |||
| 1. , , / Full name | |||
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Date of birth Seamans passport No. | |||
| : ( ) Has served on: (Name of vessel) | |||
| Π IMO Number Port of registry | |||
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Gross Tonnage Type of vessel | |||
| 蠠 Propulsion power kw Type of Main Propelling Machinery | |||
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Power of ships electrical equipment kw Kind of carried cargo | |||
| ( )/Area of operation (ports of call) | |||
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| /from /to | |||
| / in the capacity of | |||
| / under my command | |||
| 2. : /During this period the above named crew member: ) / * was in full charge of a deck/engine* watch for not less than _______________________/hours. | |||
| 24 / * . Out of every 24 hours service claimed whilst the vessel was engaged in unlimited/coastal* voyages b) , / carried out duties connected with radio communications: /yes* /none*, / including using GMDSS equipment: /yes* /none* | |||
| 3. :/ On the grounds of the above the complete length of seagoing service is: | |||
| a) / total time of seagoing service / months /days | |||
| b) c / time of watchkeeping service: /months /days
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| / Note: * /delete as appropriate
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| /Master: | |||
| / Signature ...( )/Name (in BLOCK letters)
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| / Chief Engineer:
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| / Signature ...( )/Name (in BLOCK letters) | |||
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/ Ships Stamp and Date
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| /Authorized Official of Company:
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| /Signature ...( )/Name (in BLOCK letters)
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| /Companys Stamp and Date | |||
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| 29 (.2) | ||||
| / TESTIMONIAL | |||||
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| This report on the service of the above-named seafarer has been drawn up by me during the period whilst he was on | |||||
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| the ships board according to this certificate: | |||||
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| /Conduct:* |
unsatisfactory |
satisfactory | good | ||
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| /Experience:* |
unsatisfactory |
satisfactory | good | ||
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| /Ability:* |
unsatisfactory |
satisfactory | good | ||
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| /Sobriety:* |
unsatisfactory |
satisfactory | good | ||
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| /Promotion:* |
not recommended |
possible in the future | recommended | ||
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| /Special remarks: | |||||
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| / Signature of Master: |
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| ...( ) : Name (in BLOCK letters) of Master: |
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| :** Signature of Chief Engineer: ** |
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| ...( ) :** Name (in BLOCK letters) of Chief Engineer:** |
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| Signature of authorized official of Company |
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| ...( ) : Name (in BLOCK letters) of authorized official of Company: | |||
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Ships Stamp and Date
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Companys Stamp and Date | ||
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| / Notes: | * /Tick where applicable | ||
| ** /for persons of Engine Department. | |||
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