CERTIFICATE OF NATIONALITY

Issued under the provision of

Minister of Transportation Regulation Number PM 13 Year 2012 Article 59

The Undersigned
Declares that:
PORT OF
NAMA OF SHIP CALL SIGN REGISTRATION MARK
REGISTETRY
- - -

GROSS NET
DIMENSION
TONNAGE TONNAGE YEAR OF BUILT
P X L X D (M)
(GT) (NT)
- - -

MAIN SHIP’S NO.OF NO.OF

MERK HP/KW
PROPULSION MATERIAL DECK PROPOLLER
- - - -

Owned ………………………………………………….….at……………….........................has complied as Indonesian

Vessel In accordance with the provinions of applicable regulation, and therefore is entitled to fly the
Indonesian Flag.

To all authorithies and officials of the Republic of Indonesia and all other to whom this may concern
are therefore requested to give appropriate treatment to the master with his vessel and cargoes in
accordance with the provisions atipulated in the laws of the Republic of Indonesia and the treaties
conculuded with other souvereign countries.

Issued at :
Date :
Ob. MINISTER OF TRANSPORTATION
Recorded in the register of
Certificate of nationality in :
Serial Number :
Page No. :
Reg. Book :