ARINAH SHIPPING SERVICES PVT. LTD.

RPSL NO: MUM-162048

Document No. ASS/RPSL/DECL Date: / /

Arinah Shipping Services Pvt. Ltd. – Hereinafter referred to as ASS

Declaration by Seafarer

Name of the Seafarer (Joiner) :

Rank :

Passport No: - :

CDC No: - :

INDOS No: - :

Joining Vessel Name/ Type :

Port of Joining :

Proposed date of Joining :

DECLARATION
I hereby declare that the information submitted above is to the best of my knowledge and nothing has been
concealed there in. I also declare that the Vessel Particulars / Vessel Condition have been declared by the
RPS employee to me before the joining and I am ready to work on the above mentioned vessel.

I also declare that I have not paid any service charges, agency fees or any joining expenses (Air Ticket
cost, Visa cost, Pre Joining, Medical cost) regarding my ship joining to the said RPS (ASS) or the Ship
Owner or any of the company employees related to the RPS.

I also declare that I have read and understood the Company “Seafarer Recruitment policy”

The company has made me aware of all the rules and regulation/ company policies and I agree to abide
them and to follow them.

_________________
Seafarer Signature

Seafarer Thumb Impression _______________ ________________

Left Right

Place: Seawoods Darave – Navi Mumbai

T-17A, 3rd Floor, Haware Centurion Complex, Sec-19A, Seawoods Darave, Navi Mumbai: 400 706
Email id: arinahshipping@gmail.com | Contact no: 7738369535