Check List and Forms File Issue Date NOv.2020 Revision Date Issue Status 1 Revision Status FINAL WAGES ACCOUNT FORM Notes: 1-This form should be filled & sent to the ship management with the sign-off report. 2-The month in dates should be put in letters only like Jan-Feb, etc. Seafarer’s & Vessel Information: |_Name of the Seafarer: JETDRIS Rank on board: AB Reference No. : Vessel Name : MV HAILONG BRAVO | Date: 28-FEB-2023 Employment Information: Date Commenced : 17-NOV-20 Date Completed : Monthly Wages : 7.000.000 (IDR) _| Total days Onboard : Wages Calculation Ne Description Deducted Amount Earned Amount 1_| Total Wages 7.000.000 (IDR) 2__| Bonus 0 (IDR) 3__| Re-joining Bonus (IDR) 4 _| Travelling & Visa Cost 0 (IDR) 5 _| Other Earning 0 (IDR) 6 _| Cash Advance (IDR) 7 _| Allotments Remitted (IDR) 8 _| Other Deductions (IDR) —— Total ===> 0 (IDR) 7.000.000 (IDR) Balance 0 (IDR) Final Balance will be paid into the nominated Bank account as per the following details declared by the seafarer: [BankName: | BANK NEGARA INDONESIA (BNI) Beneficiary Name : | JEDTRIS Account No. 0984309326 (IDR) | Bank Address : DESA BUNTUTALLANG, INDONESIA LIBAN/IFSC Code : | Swift Code : BNINIDJA Seafarer’s name & signature: JETDRIS a Office use only: Fleet Personnel manager/other | BIMIKS Industrial Equipment FZCOPace 10F 1 Check List and Forms File [Issue Date [NOv-2020 Revision Date Tesue Status, [or Revision Status FINAL WAGES ACCOUNT FORM Notes: 1-This form should be filled & sent to the ship management with the sign-off report. 2-The month in dates should be put in letters only like Jan-Feb, etc. Seafarer’s & Vessel Information: Name of the Seafarer: JETDRIS Rank on board: [AB Reference No. : Vessel Name MV HAILONG BRAVO | Date : 31-MAR-2023 Employment Information: [Date Commenced : 17-NOV-20 [Date Completed: | | Monthly Wages : [_ 7.000.000 (1DR)__| Total days Onboard : | Wages Calculation: No. | Description Deducted Amount | _Earned Amount 1 Total Wages 7.000.000 (IDR) 2__| Bonus 0 (IDR) 3__| Re-joining Bonus 0 (IDR) 4 _| Travelling & Visa Cost ‘0 (IDR) 5__| Other Earning 0 (IDR) [6 _| Cash Advance 0 (IDR) 7__| Allotments Remitted 0 (IDR) 8 _| Other Deductions 0 (IDR) ———— Total ===> 0 (IDR) 7.000.000 (IDR) Balance 0 (IDR) Final Balance will be paid into the nominated Bank account as per the following details declared by the seafarer: | Bank Name : BANK NEGARA INDONESIA (BNI) | Beneficiary Name : JEDTRIS Account No. (0984309326 (IDR) Bank Address : DESA BUNTUTALLANG, INDONESIA | | IBAN/IFSC Code : is Swift Code : BNINIDJA Office use only: | Seafarer’s name & signature: Fleet Personnel manager/other JETDRIS a BIMIKS Industrial Equipment FZCOCheck List and Forms File Page 1 oF 4 @ Rov ET eel ease i Ramen rai FINAL WAGES ACCOUNT FORM Notes: 1-This form should be filled & sent to the ship management with the sigi 2-The month in dates should be put in letters only like Jan-Feb, ete. 1n-off report. [Seafarer’s & Vessel Information: Name of the Seafarer: JETORIS Rank on board: AB Reference No. : | Vessel Name : ‘MV HAILONG BRAVO | Date: 30-APR-2023 Employment Information: Date Commenced : 17-NOV-20 Date Completed : Monthly Wages : 7.000.000 (IDR) _| Total days Onboard : Wages Calculation: No. Description Deducted Amount | Earned Amount 1_| Total Wages 7.000.000 (IDR) 2_| Bonus (IDR) 3__| Re-joining Bonus (IDR) 4_| Travelling & Visa Cost (IDR) 5 __| Other Earning (IDR) 6 _| Cash Advance (IDR) 7 _| Allotments Remitted (0 (IDR) 8 _| Other Deductions (IDR) Se Total ===> (IDR) 7.000.000 (IDR) Balance (IDR) Final Balance will be paid into the nominated Bank account as per the following details declared by the seafarer: BANK NEGARA INDONESIA (BNI) Bank Name : | Beneficiary Name : JEDTRIS | Account No. 0984309326 (IDR) | Bank Address : DESA BUNTUTALLANG, INDONESIA IBAN/IFSC Code : Swift Code : BNINIDIA Seafarer’s name & signature: JETDRIS Office use only: Fleet Personnel manager/o