SEAFARER EMPLOYMENT AGREEMENT

SACOM ENERGIA
This Seafarer Employment Agreement has been entered voluntarily for a fixed period
between the following two parties, Seafarer and Owner, as per terms and conditions set out
hereinafter.
Therefore it is fully understood by all parties that the Seafarer Employment Agreement is
between the Owner and the Seafarer, with Thome Offshore Management acting as agent
only for and on behalf of the Owner.

Personal details of Seafarer:

Compas Crew ID Surname First and middle name(s)

Date of birth Place of birth Nationality Passport no.

Passport expiry date Seaman’s book no. Seaman’s book expiry date

Marital status Recruitment & Placement Seafarers residential address

Service
Married
Single

Hereinafter referred to as the Seafarer

Details of Owner:

Name of Owner Owners address (place of registered office)

Hereinafter referred to as the Lawful Owner

Details of the Ship Manager (as agents only) who under the Maritime Labour Convention 2006
has assumed the responsibility for the operation of the ship from the Lawful Owner:

Ship Manager as agent only for and on behalf of the Lawful

Owner
Thome Offshore Management Pte. Ltd
16 Raffles Quay
#43-01 Hong Leong Building
Singapore 048581

Hereinafter referred to as the Employer

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1. Terms and conditions :

Ship’s name IMO Number Ship type Ship’s deadweight

WM SULAWESI 9280914 PSV 3279.9

Ship’s flag SEA commencement date Point of employment (airport)

INDONESIA
SEA duration (+/- 1 month) Rank Collective Bargaining
Agreement

MONTH/S NON CBA.

Distance to airport Travel allowance Leave days earned Leave pay retention
per month

KMS NOT APPLICABLE 7.5 DAYS NOT APPLICABLE

Working hours Health Insurance Health Insurance Health insurance validity
(weekly) provider Membership no. From To

48 HOURS NOT APPLICABLE NOT APPLICABLE N/A N/A

The Ship’s Articles and the Maritime Labour Convention 2006 shall form an integral part of this
agreement and shall supersede the terms and conditions set out in this Crew Employment
Agreement when considered more favorable to the Seafarer.
Every effort will be made by the Employer to relieve the Seafarer upon completion of the
Agreement, but the Employer reserves the right to extend or shorten the contract duration of
the Seafarer Employment Agreement by plus or minus one month for reasons of Operational
convenience or convenience of the port of call.
The point of employment is considered to be the nearest international airport to Seafarers
residential address and the commencement date of this Seafarer Employment Agreement is
considered to be the departure date from the point of employment.

2. Monthly Remuneration
Basic Day Rate ( US$ ) Leave pay Fixed overtime Choose an item.

Seniority allowance Seniority Allowance Owners Seniority Old Ship allowance

“in Thome” (if “in Rank” (if allowance (if (if applicable)
applicable) applicable) applicable)

NOT APPLICABLE NOT APPLICABLE NOT APPLICABLE NOT APPLICABLE

Higher license bonus Uniform allowance Total Monthly Wages (US$) (Total All Inclusive
(If applicable) (if applicable) Day Rate (US$) with Leave Pay & OT)
USD per day x days = $ 0.00
NOT APPLICABLE NOT APPLICABLE USD per day x days = $ 0.00

The above remuneration are in US$ (United States Dollar) and will be effective from the date
of commencement of this Agreement.
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SACOM ENERGIA
3. Payment and calculation of wages
The earnings are paid monthly in arrears with deductions made for any personal expenses
that the Seafarer has incurred, such as cash withdrawals, slop-chest, communications, etc.
The Employer pays a day rate salary, therefore, a seafarer is paid for the amount of days he
spends travelling to join (from his point of employment), aboard the vessel & when he arrives
back at his point of employment.
If the country of residence of the Seafarer has regulations for compulsory allotments, then this
will be paid in the home country and deduction will be made from wages onboard.
A monthly pay slip with account of payments due will be provided by the Master to the
Seafarer at the end of each calendar month and prior to sign off.
During sign off, in cases where it is not practical to provide a pay slip, a tentative wage
account will be provided for reference. Once the flight and other details are finalised, the
final wage account shall be provided to the Seafarer directly or indirectly through the
Recruitment Agency, for the Seafarer’s confirmation.

4. Leave days
The earnings for leave pay is included in the total all inclusive day rate.
The Seafarer will be entitled to the number days of leave, as entered under clause 1 (terms &
conditions), for each completed calendar month of service and pro rata basis for every
incomplete month of service. Time spent awaiting repatriation and repatriation travel time
shall not be deducted from paid leave accrued by the seafarer.

5. Hours of work & Overtime

The working hours, inclusive of overtime, are as listed under clause 1 (terms & conditions) and
as specified below:
a) 12 Hours per day from Monday to Sunday and Holidays (8 hours normal & 4 hours
overtime).

The seafarer should only work a 12 hour day, unless there are emergency drills or emergency
situations that require his / her attendance, as required for the safe operation of the ship. His
fixed daily rate is inclusive of all overtime payments and times worked during holidays.

6. Holidays
For the purpose of this agreement, the national holidays of the flag state shall be considered
as holidays at sea or in port. If a holiday falls on a Saturday or Sunday, the following working
day shall be observed as a holiday. National holidays shall be subject to a minimum of nine
(9) days.

7. Uniform allowance & Working gear

A uniform allowance, as under clause 2 (monthly remuneration), will be paid to the Seafarer.
If uniform is supplied by the Employer before the Seafarer joins, uniform allowance will not be
applicable to that particular tour of duty.
One pair of Safety boots / shoes and two boiler suits will be supplied in addition to the above
by the Employer aboard the ship upon joining.

8. Employers health insurance scheme

The Employer affirms that the assigned ship is covered by P&I insurance for crew members
working aboard, which provides cover pursuant to the relevant terms of this contract and as
per the rules of the P&I club.
The Employer may offer additional health insurance to the Seafarer effective from the
commencement of the second Seafarer Employment Agreement and this will be stated
under clause 1 (terms and conditions) if the seafarer is entitled. The health insurance scheme
will provide the Seafarer with medical benefits both while aboard and during leave.
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9. Travel wages including office briefing in Singapore
Full wages will be paid during travel to and from the ship and the entitlement to wage
commences upon departure from the point of employment and ends upon return to the
point of employment. The day in which travel starts and ends will be counted as a full day.
The Seafarer will receive full day rate wage during briefing in the Employers office in
Singapore.
If the seafarer returns home after briefing to await the joining his / her ship, then the day rate
wage will be terminated when the Seafarer returns to the point of employment and payment
of day rate wage will start again when the Seafarer departs from the point of employment to
join his / her ship.
The Seafarer will be reimbursed for travel expenses incurred to join and leave his / her ship.
Valid vouchers / receipts have to be presented for these costs to be reimbursed to the
Seafarer.

10. Taxes and pension

The Seafarer is responsible for reporting and settling own tax as well as pension according to
the requirements of the Seafarers home country and the ship’s flag state.

11. Cash advance aboard & allotments

The Seafarer will be allowed to draw cash advance up to the amount of earnings standing
against the Seafarer’s name.
At no time will the account be allowed to run into negative balance and it must comply with
requirements for leave pay retention under clause 4 and any regulations for compulsory
allotment in the Seafarer’s country of residence.
Cash advances onboard will, as far as possible, be made in US Dollars. Notwithstanding this,
the company will endeavor to make advances in local currency at the port of call.
The employer will provide the facility of sending one monthly allotment to the Seafarer
without any cost. The deadline for submission of allotment request to Marine Payroll through
the Master is on the 15th of the month and remittance will be made by the Employer on 25th.
of the month. The Seafarer should have a sufficient earned balance and calculation of the
balance should be made until 25th of the month. A copy of the debit advice will be provided
to the Seafarer as evidence of the remittance.
Bank charges for any additional allotments are for the Seafarer’s account.
The Seafarer must provide the manning agent with full bank details for a maximum of five (5)
bank accounts to be used for any remittance by completing Appendix D prior to joining,
and the Employer accepts no responsibility for any delay in the remittance of allotments as a
result of incomplete or incorrect bank details provided by the Seafarer. The Seafarer shall in
no instance request for remittance to a bank account other than these five (5) pre-registered
accounts.
12. Final wages
The Final wages, will as far as possible, be paid in US Dollars prior to signing-off from the ship
with Final wage confirmation from Marine Payroll.
However, in the event of currency restrictions prevailing in the sign-off port, the employer will
pay the Final wages in local currency if the Seafarer so desires. If, in exceptional
circumstances, funds are not available aboard or from agents, the employer will settle the
Final wages within a month by remitting into the Seafarer’s nominated bank account.

13. Pre-Employment Medical Examination

The Seafarer must have Pre-Employment Medical Examination valid until the end of their due
contract date prior to every joining and must comply with the requirements by the employer
and those of the flag state.
The cost of Pre-Employment Medical Examination will be borne by the Employer.
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14. Medical attention, sick pay, death and disability
The Employer shall bear the cost for the Seafarer in respect of sickness and injury that occur
during service aboard or while travelling between the ship and the point of employment and
the Employers office in Singapore for briefing during joining sign on or upon sign off.
Only sickness or injury that is shipboard-related, and not arising from self-infliction or
negligence of the Seafarer, as determined by a company-approved doctor at the port of
disembarkation or within 72 hours upon reaching country of domicile by company approved
doctor, will be covered.
If the seafarer is landed at any port because of sickness or injury, pro-rated payment of basic
wages plus fixed overtime, will continue until repatriation to the point of employment at the
Company’s expense.
Thereafter the Seafarer shall be entitled to sick pay at the rate equivalent to their basic wage
while the Seafarer remains sick up to a maximum of 130 days. The provision of sick pay
following repatriation shall be subject to submission of a valid medical certificate without
undue delay.
A seafarer who suffers permanent disability as a result of an accident whilst in the
employment of the Employer regardless of fault, including accidents occurring while
travelling to or from the ship, and whose ability to work as a seafarer is reduced as a result
thereof, but excluding permanent disability due to willful acts, shall in addition to sick pay, be
entitled to compensation according to the provisions of this Agreement.
The disability suffered by the seafarer shall be determined by a doctor appointed by the
Company.
The Employer shall provide disability compensation to the Seafarer in accordance with
Appendix F, with any differences, including less than 10 % disability, to be pro rata
If the Seafarer dies through any cause whilst in the employment of the Employer including
death from natural causes and death occurring whilst travelling to and from the vessel, or as
a result of marine or other similar peril, but excluding death due to wilful acts, the Company
shall pay the sums specified in the attached Appendix F to a nominated beneficiary and to
each dependent child up to a maximum of 4 (four) under the age of 18.
The employer will not pay any expenses incurred in respect of illness or disability arising from
attempted suicide, misuse of drugs or medications, excessive consumption of alcohol,
participation in any hazardous activities, and/or the performance of any unlawful act.
The Employer affirms that the assigned ship is covered by P&I insurance, which provides
compensation for occupational injury, illness or death pursuant to the terms of this contract
and as per the rules of the Club.
At the time of medical examination, the Seafarer is obliged to disclose to the doctor true and
complete information about, and relevant to, his past and present health status. Any
continuing medication needed and surgical operation undergone must be disclosed as well
to both the doctor and the Employer. If the Seafarer fails to disclose or give false information
about his medical history and current health, the Seafarer is liable for all costs and expenses
suffered or incurred by the Employer as a consequence thereof. P&I coverage will not apply
in such cases.
The employer shall pay the cost of burial expenses in the case of death occurring on board
or in the case of death occurring ashore, if at the time the seafarer was entitled to medical
care and maintenance.
The employer or their representatives shall take measures for safeguarding property left on
board by a sick, injured or deceased seafarer and returning it to the seafarer’s next-of-kin.
The same requirement can be referenced V-ENC-160.

15. Dental / Optical effects

The employer will not bear the expenses of the following:
1. Prophylactic dental treatments (e.g. cavity filling)
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SACOM ENERGIA
2. Optical appliances (spectacles), except for loss or damage resulting from the Seafarer’s
service onboard provided it is not due to negligence of the Seafarer.

16. Loss of personal effects

The Employer will compensate the Seafarer for a total or partial loss/damage to his personal
effects capped to a maximum amount of USD 3,000, either while travelling to/from the ship
or whilst serving onboard, provided that the loss or damage is not arising from negligence on
the part of the Seafarer. The Seafarer shall certify that any information provided with regard
to lost property is true to the best of their knowledge.
Any amount of cash, negotiable instruments, precious or rare metals or stones, valuable
objects of a rare nature are not counted as personal effects and are therefore not
refundable in case of loss or damage.

17. Termination of service

The Seafarer may terminate this Agreement by giving one month (1) written notice.
The Employer may terminate this agreement by giving one month (1) notice to the Seafarer.
If the circumstance of the termination is due to no fault of the Seafarer, the employer will pay
1 month of full day rate as compensation, and will also be responsible for repatriation cost to
the point of employment (if the agreement is terminated with less than 1 month remaining,
then this compensation is not paid).
The Seafarer may be discharged in case of misconduct, negligence, or incompetence within
the period of this Employment Agreement and will in such case only receive wages up to
and including the day of termination. The Seafarer will in such case be responsible for all
expenses including own airfare, which would not have arisen if the Seafarer had completed
the Employment Agreement.

18. Repatriation & travel

The Seafarer shall be entitled to repatriation at the cost of the Employer:
1. Upon expiry of the contractual period of the Seafarer's Employment Agreement; or
2. When the Seafarer’s Employment Agreement is terminated by the Employer; or
3. When the Seafarer’s Employment Agreement is terminated by the Seafarer on
compassionate grounds; or
4. When the seafarer is no longer able to carry out duties under the Employment Agreement
or cannot be expected to carry them out in specific circumstances, as follows: a. in the
event of illness or injury or other medical condition which requires the Seafarer’s repatriation,
when found medically fit to travel; or
b. in the event of shipwreck; or
c. in the event of the Employer not being able to continue to fulfill their legal or contractual
obligations as an employer of the Seafarer by reason of insolvency, sale of ship, change of
ship's registration or any other similar reason; or
d. In the event of a ship being bound for a war zone, as defined by national laws or
regulations or the Seafarers’ Employment Agreement, to which the seafarer does not
consent to go.

However, in the event that the Seafarers’ Employment has not expired, the Employer shall
have the right to transfer the Seafarer to another of the Employer’s ships, to serve the
balance of the employment period, unless otherwise provided.
The Seafarer shall forfeit the right to repatriation in case of:
1. Rightful dismissal; or
2. Desertion; or
3. Criminal offenses; or
4. Unjustifiable repudiation of the Shipping Articles
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The Seafarer is entitled to repatriation by means of the most expeditious mode of transport,
which normally considered being air transport. The employer will make the necessary travel
arrangements and bear the costs for any required accommodation and transport.
At all times the Seafarer will travel economy class and will be entitled to a baggage
allowance of 40 kg. Any extra baggage expenses incurred will be paid by the Seafarer.
Travel allowance described under clause 1 and clause 9 of this Seafarer Employment
Agreement will be paid to cover expenses during travelling, such as food, airport tax and
transport between home and the ship.

19. Probation period

The probationary period shall only apply during the first term of employment with the
Employer and the duration shall be equivalent to one third of the employment term stated in
the Seafarer Employment Agreement, capped to a maximum of ten weeks.
The Employer shall be entitled to terminate the Agreement during the probation period if the
Seafarer shows unsatisfactory performance, which is confirmed through appraisals by Senior
Management aboard or by Senior Management in the Employers office.
The Seafarer will in such case be entitled to repatriation at the cost of the Employer.
However, in such an event compensation for premature termination of employment
provided shall not apply.

20. Compassionate leave

The Seafarer may terminate the Seafarers’ Employment Agreement without notice in the
event that the Seafarer can show medical proof that a next-of-kin has been diagnosed with
a serious health condition. The Seafarer will be entitled to repatriation at the cost of the
Employer at the first convenient port, provided that a reliever is available.
If the Seafarer is married, spouse and children will be considered to be “next of kin”. If the
Seafarer is single, parents will be considered to be “next of kin”, unless otherwise agreed and
declared in the Seafarer Employment Agreement.

21. Documents & certificates

The Seafarer will be required to carry all original documents and certificates, which are
considered necessary for his service onboard the ship to which the Seafarer is assigned. Any
expenses that the employer may incur as a result of the Seafarer’s lack of compliance will be
chargeable to the Seafarer. Without limiting the foregoing, such documents will include:
1. Passport with validity of not less than 6 months beyond the expiry date of the Seafarers’
Employment Agreement and having at least 2 blank pages.
2. International vaccination card with yellow fever vaccination valid for the duration of the
Seafarers’ Employment Agreement.
3. Certificate of competency valid for the duration of the Seafarers’ Employment Agreement
4. Certificate for courses which are mandatory as per STCW 2010 with validity for the duration
of the Seafarers’ Employment Agreement.
5. Certificates for any extra courses which the officer may have attended
6. Medical certificate with validity for the duration of the Seafarers’ Employment Agreement
All expenses for any flag state certificates or visas, that are required for the Seafarer to serve
aboard the assigned ship, will be borne by the employer.

22. Training
It is the responsibility of the Seafarer to ensure that all certificates, as required by STCW 78/95
as amended, are maintained and valid at the Seafarer’s own cost.
The Seafarer is expected to actively participate in value added training, Officer seminar’s and assessments
both ashore and aboard, such as Seagull Computer Based Training, Crew Resource Management training
and any other courses required as per company training matrix.
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The Company will pay course fees for non ‘STCW 78/95’ courses (value added) and all
related expenses when the Seafarer attends officer seminars, which are required by the
employer. There are no wages paid to the Seafarer during attendance of such training and
seminars.

23. Service in warlike or high risk areas

A Warlike Operations Area shall be determined by the IBF Warlike Operations Areas
Committee. If the ship enters a Warlike Operations Area,
• The Seafarer shall have the right not to proceed to such an area. In such cases, the
Seafarer shall be repatriated at the cost of the Employer with benefits accrued until the date
of return to the point of employment.

• The Seafarer shall be entitled to a double compensation for disability or death.

• The Seafarer shall also be paid a bonus equivalent to 100% of the basic wage for the
duration of the ship’s stay in a Warlike Operations Area, subject to a minimum of 5 day’s pay.

In addition to Warlike Operations Areas, the IBF may determine High Risk Areas and define,
on a case-by-case basis, the applicable seafarers’ benefits and entitlements, as well as
employers’ and seafarers’ obligations that shall apply to the Seafarer Employment
Agreement.
The Seafarer has been made aware that the ship he or she is assigned to by the Employer
may be transiting or trading from time to time in the Gulf of Aden, a currently established
High Risk Area, and therefore shall be agreeable to work onboard while the ship is transiting
or trading in this area under the terms and conditions as established by the IBF.
The Employer has adopted BMP4 (best management practices) into their procedures as a
precautionary measure to protect the seafarers whenever their ship transit Warlike
Operations or High Risk Areas.

24. Extension of Seafarer Employment Agreement (SEA)

The Seafarer may request extension of the agreement and every effort will be made to
accommodate the request, but maximum extension should not be more than 1 month.
The request should be submitted as early as possible after joining.

25. Vaccinations
The Seafarer shall conform to the laws of any country within the territorial jurisdiction of which
the ship may be subject to during the course of its voyage. In the event that such laws
require vaccination or inoculation for the purpose of enabling the ship to secure a clean bill
of health, the Seafarer shall, at the request of the employer and at the employer’s expenses,
and at any time during the period of this agreement, subject him or herself to such
vaccinations or inoculations. Yellow fever vaccination is compulsory prior to joining any ship.

26. Work and rest hours

The employer has adopted the STCW, ILO and OPA90 work & rest hour regulations into its
policies, and the Seafarer is required to strictly adhere to these policies and regulations.
It is also the responsibility of the Seafarer to maintain own work and rest hour records
onboard as per above named regulations.

27. Dress code and personal protection

The Seafarer must at all times comply with the company’s dress code policy as set out in the company’s
Safety Management System (SMS), which, amongst others, require all officers to wear uniform or clean
boiler suits with name tags and helmet while in port.
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The Seafarer must always ensure correct use of Personal Protective Equipment as per
company policy described in the Safety & Health Manual.

28. Drug & alcohol

The employer is a signatory party to the U.S. Sea Carrier Initiative Agreement, which was
signed in connection with the U.S. Anti Drug Abuse Act 1986, and is also committed to a Drug
and Alcohol Policy as per OCIMF guidelines of January 1995.
The Employer practices a strict zero tolerance towards the use of unprescribed drugs or
controlled substances on board ships. Anyone in possession of illegal drugs or controlled
substances will immediately be removed from the ship and turned over to the relevant
authorities. Illegal drugs and controlled substances include, but are not limited to, Marijuana,
Cocaine, Opiates, Phencyclidine (PCP) and Amphetamines. If the Seafarer is required to
consume any medicine or drugs, prescribed by a Qualified Medical Practitioner, the Master
of the ship or respective Manager should be informed, so that the individual's drug usage
can be monitored, and daily work routine can be adjusted as and where appropriate.
The Seafarer, therefore, has to comply with the following:
1. Not to be or have been addicted to any drugs and neither being a drug user.
2. Not to be engaged or connected in any way with drugs or peddling of drugs.
3. Full cooperation with relevant authorities to assist with any drug smuggling/trafficking
investigation.
4. To consent to thorough medical examination including random testing for drugs and
alcohol as per Company Drug and Alcohol Policy, if required.
5. To be aware that any breach of the Company Drug and Alcohol Policy may result in
immediate dismissal and that the Seafarer will be liable for all costs related to the repatriation
and the cost of his or her reliever.

6. To undertake to pay in full all claims, damages, costs and expenses whatsoever, which
may be taken or made against the Employer or Lawful Owners, if the Seafarer should be
found in unlawful possession of drugs
The Company Drug and Alcohol Policy including Addendum 1 are attached to this contract.
Addendum 1 does not apply across all ships and it is therefore the Seafarer’s responsibility to
be familiar with the policies onboard the assigned ship, immediately upon joining.

29. Health, Safety and Environmental policy

The Employer is committed to foster a safe and healthy work environment, and adopts a
strategic and long-term approach to achieve sustainable, continuous improvement in
occupational health and safety.
It is the responsibility of the Seafarer to familiarize him or herself with all safety and health
procedures implemented by the Employer and to strictly comply with them to minimize
safety hazards and prevent injury to themselves, their colleagues and property.
The Seafarer must also promote the high standards of safety and health consciousness,
discipline and individual accountability onboard, according to the Employer’s requirement.
The Employer has established an Environmental Management System (EMS) in conformance
with ISO 14001 as a means for the Employer to implement its environmental policies and
objectives.
The purpose of the environmental policies and objectives is to achieve environmental
excellence in all aspects of the Employer’s business operations.
It is the responsibility of each Seafarer to know the Employer’s environmental objectives and
policies and to embrace the concepts detailed in daily work routines.
The Employer exercises a zero-tolerance approach to any non-compliance or violation with the
International Convention for the Prevention of Pollution from Ships (MARPOL). Notably, International
Maritime Organization (IMO) requirements concerning the use of Oily Water Separators and the
monitoring and discharge of oil into the sea must be strictly adhered to.
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The zero-tolerance approach also extends to any industrial best practices that the Company
has adopted through revised Safety management procedures or HSSEQ Circulars.
All Seafarers joining the Employer’s managed ships are required to sign the TSM Form 075F
confirming the familiarization and understanding of the Employer’s requirements.

30. Record of employment

The Seafarer shall have their record of employment entered in the seafarer’s identification
and record book (“SIRB”). The SIRB document shall not contain any statement as to the
quality of the seafarers’ work or as to their wages.

31. Company Crew Complaint procedures

The Company Crew Complaint procedures are outlined in Appendix B.

32. Applicable law

Any unresolved dispute, claim or grievance arising out of or in connection with this Contract,
including the annexes thereof, shall be governed by the laws of the Republic of the flag
state, international conventions, treaties and covenants where the flag state is a signatory.

33. List of appendixes, forms and policies

The following forms and appendixes forms part of the Seafarers Employment Agreement and
must be attached:
o Appendix A - Disability compensation scheme.
o Appendix B - Crew Complaint.
o TOM form no. 075F - Crew Environmental Management System Declaration.
o TOM form no. 043 - Letter of undertaking (drug & alcohol).
o Drug and Alcohol policy including addendum no. 1.

34. Confidentiality
The Seafarer shall maintain confidentiality in all matters relating to the ship, the onboard and
shore based management. No information of any nature whatsoever shall be
communicated or disclosed to any outside party.
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Yours faithfully
on behalf of SACOM ENERGIA
“I hereby confirm that I have read and fully understood the above terms and conditions at
the time of my appointment. Further to that, I voluntarily agree to these terms and will
comply therewith in every respect. I have also been made aware of my rights to examine
and seek advice on the agreement before signing.
I acknowledge receipt of the original Agreement letter and attest that no fee or any other
charges have been requested from me for my recruitment or placement directly or
indirectly, in whole or in part, other than the cost of obtaining my national statutory medical
certificate, national seaman’s book and passport or other similar travel documents, except
for the cost of visas, which shall be borne by the employer”.

_________________________________ ________________________________
Signature of person signing Signature of Seafarer
on behalf of the Owner

Name : Name :
Date : Date :
Place : Place :

** Two original copies of the Seafarer Employment Agreement must be signed. An original
must be with the Seafarer and an original with the Owner or manning agent.

Next of kind

1. Name :
Relationship :
Address :

2. Name :
Relationship :
Address :

Details of children

1. Name :
Date of birth :

2. Name :
Date of birth :

3. Name :
Date of birth :