Nr.
ADEVERINTA PRIVIND STAGIUL DE AMBARCARE
PE NAVE SUB PAVILION STRAIN ( SEA SERVICE CERTIFICATE)
NUMELE SI TIPUL NAVEI
(NAME AND TYPE OF VESSEL)
TONAJ BRUT NAVA
(GROSS TONNAGE)
PUTEREA MOTORULUI PRINCIPAL IN
KW
(M.E. POWER)
NUME SI PRENUME
(NAME AND SURNAME)
FUNCTIA
(RANK)
NR. CARNET MARINAR
(SCHIFFERDIENSTBUCH NO.)
NR. BREVET/ CERTIFICAT
CAPACITATE
(LICENSE NO.)
DATA AMBARCARII
(DATE OF ENGAGEMENT)
LOCUL AMBARCARII
(PLACE OF ENGAGEMENT)
DATA DEBARCARII
(DATE OF DISCHARGE)
LOCUL DEBARCARII
(PLACE OF DISCHARGE)
NUMELE SI SEMNATURA
COMANDANTULUI NAVEI
(NAME AND SIGNATURE OF MASTER)
STAMPILA NAVEI
(STAMP OF VESSEL)
We, the undersigned crewing company, hereby confirm that
Mr.______________________________________________________________ have been embarked on
board____________________________________________________________, serving as
_________________________________ between______________________/_________________________
Signature of the company official,
_______________________________
Stamp