Private Instrument of Release Agreement

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PRIVATE INSTRUMENT OF RELEASE AGREEMENT

Mr. Eka Ridwansyah (employee nr.799214) born on april 1. 1995 in purwakarta (Indonesia) –
passport nr. B 5007542 issued by the Republic of Indonesia, workef on board Costa Crociere’s
veesels as an housekeeping steward. He started his second contract on costa Magica on April
21. 2019 (contract nr 2019.15953/0) employed by cruies ships catering and services international
N.V. Permanent establishment, in Italy. During his contract he asked for medical assistance to the
onboard hospital. After assessment, he was disembarked on medical reasons and hospitalized by
Meilahti Tower Hospital in Helsinki (Finland) on August 12, 2019. His conditions worsened while
in the hospital, was transferred to the intensive care unit. On August 15, 2019 he passed away.

His body and his personal belongings were repatriated, once all legal requirements have been
complied with, for the funeral ceremony. The cost of the funeral ceremony was shouldered by his
employer

Mr. Eka Ridwansyah was single and didn’t have any children. He didn’t leave any last will

Accourding to the Affidavit of Heirship signed on January 20, 2021 his mother. Mrs. Neneng
Sugriwati is the legal heir of late Eka Ridwansyah at 100 % of his estate

With Such premises.

I, Mrs. Neneng Sufriwati, born in Purwakarta (Indonesia) on September 28, 1963 ID nr.
3214016809630002, widow,

Declare

In my power as a legal heir of my late son Eka Ridwansyah to receive the amount of US Dllars
60000.00 (sixty-thousand US Dolar) a sum of the amounts below specified :

. USD 60.000.00 (sixty-thousand US Dolar) as heir at 100 % of the contractual liability foreseen
by article 15.6 of the applicable. Collective bargaining agreement signed on June 30,2017 by and
between the Italian Shipowner’s Association (Confitarma), cruise Ships Catering and services
International NV, and the Italian Trade Unions Associations;

To be credited by Cruise Ships Catering and services International NV, permanent Establisment
in Italy a on Following account. Payment will be done in three (3) Monthly installments of 20.000
(twenty thousand) US Dollars each. Starting with the month of the receipt of all original
documents in the headquarter in Genoa. Commissions due to exchange rate from US Dollars to
Indonesia Rupees and Commissions charged by the recipient’s bank, are shouldered by the
beneficiary

Bank Name : Bank Central Asia (BCA) KCU PURWAKARTA

Bank Address : BCA KCU PURWAKARTA, JALAN JENDERAL SUDIRMAN 85, 41114

Beneficiary : MRS NENENG SUGRIWATI

Swift Code : CENAIDJA

Account No : 2310393811

This release is in full and final settlement of, and each party that I represent hereby release and
forver
Discharges, all and /or any actions, claims, demands, rights, set-offs or complaints of whatsoever
nature, whether in this jurisdiction or any other, whether present of future and whether known or
unknown to the parties and whether arising from or affected by any change in the law or any
change of circumstances of, connected with the described event occurred to Mr. Eka Ridwansyah
any liability on the part of costa Crociere Spa and any other company of the costa group, of
companies to the same affiliated and/or connected as per article 2359 of the Italian Civil Code, of
Cruise Ships Catering and Services International NV and its Permanent Establishment In Italy, of
Carnival Maritime GMBH, of Carnival Corporation, of their P&I Clubs and the legal
representatives, directors, managers, officers, employees of the above mentioned companies, of
the crew and agents of M/V “Costa Magica” and/or any other party involved, preventing them from
any liability.

Therefore signing this release, I, Mrs Neneng Sugriwati, settle by way of compromise all the
contractual and non contractual indemnities and damages arisen for any title from the event.

I also acknowledge upon acceptance of this settlement that I am precluded, as well as the parties
that I represent, from filing any lawsuits anywhere in the world against anybody and any
corporation whatsoever, to seek recovery of damages for claims arising out of the event and/or
medical conditions that are the subject of this settlement agreement.

I understand and agree that the details of this release, including its terms and amount are
considered confidential and not to be disclosed publicly to any third party, Including any news
media sources legal verdict or settlement reports.

I’m aware that this release is duly notarised and I declare that it is real and genuine and in full
force and effect for myself and for refresented parties.

This release is executed in English and in Indonesiaan language. In case of discrepancy. The
English version prevails.

Signature and date Mrs. Neneng Sugriwati

ACKNOWLEDGMENT BEFORE NOTARY PUBLIC

On this Wednesday day of January 20, 2021, the date of the execution of the release, before me
personally came Mrs. Neneng Sugriwati, identified by me………., known to me to be the
individual described in and who executed this document, and acknowledged that they fully
understood its contents and that it was a release of everything and that each of them individually
duly executed the same as per their own free act and deed and for the sole consideration therein
expressed

NOTARIAL SEAL REQUIRED


Notary In Purwakarta,

AZHAR, SH, Sp1, MSi NENENG SUGRIWATI

KTP 3214016809630002
Affidavit of Heirship

I, Mrs. Neneng Sugriwati, born in Purwakarta (Indonesia) on September 28, 1963 Indonesian nationality,
identity card nr. 3214016809630002, after having duly sworn to in accordance with law do hereby
depose and state
 Mr. Eka Ridwansyah, was born on April 1 1995 in Purwakarta (Indonesia) – passport nr. B
5007542 issued by the Republic of Indonesia, from marriage between myself, Mrs. Neneng
Sugriwati and Mr. Aceng Tarmidi
 I’m presently widows due to the demise of Mr Aceng Tarmidi on October 14,2014
 My son Eka Ridwansyah passed away on august 15,2019 while hospitalized by meilahti Tower
Hospital in Helsinki (Finland);
 Late Eka Ridwansyah was single didn’t have any legitimate or illegitiate child;
 Late Eka Ridwansyah didn’t leave any last will;
 During the lifetime of the late Eka Ridwansyah his employer cruise ships catering and services
international NV, permanent establishment in Italy, secured an insurance policy with Helvetia vita
insurance, which includes a death clause of 12.500 euro to be paid to the heirs in case terms and
conditions specified in the policy are respected;
 According to the compilation of Islamic law (*KHI*). Article 174 paragraph (1) and paragraph (2),
which is the law applicable to inheritance in Indonesia, heirs are classified based on blood
relations and marital relations. KHI contains a provision concerning the grouping heir stipulated in
article 174 KHI, Namely : 1) group heir consists of : according to the blood relations : a) male
group
Consisting of father, son, brother, uncle and grandfather, and b) female group
Consisting of mother, daughter,,sister, and grandmother; 2) according to the marital
Relationship consists of a window or widower. If all the heirs exist. Then who is entitled to inherit
only: children, father, mother widow or widower
Applying KHI law to case of late Eka Ridwansyah, I Neneng Sugriwati am the only heir for his
estate as he was single. With no children. His father passed away. So, I have all rights for all
property,benefit or any wage that he is entitled to;
The above statements are true and to the best of my belief I’m making the afore said declaration
under the pain of perjury and prosecution of any law that I may violate by making untrue
statements
In WITNESS WHEREOF, I Have hereunto affixed my signature this January 20 of 2021 in
Purwakarta, Indonesia

Notary In Purwakarta,

AZHAR, SH, Sp1, MSi NENENG SUGRIWATI


KTP 3214016809630002

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