Place:. …………………………
2 Signed-off ashore:
Place:. ………..……….………. |
1 Signed-on ashore: |
3 Signed-off from ship: |
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| |
| |
| |
| 2 Signed-on ship: |
4 Signed-off ashore: |
|
| 6. Signature with date & stamp of master: |
12. Signature with date & stamp of shipping master: |
|
| 1 Signed-on ship:
Place:. ………………………. |
2 Signed-off from ship:
Place:. …………………………. |
1 On receipt of record of commencing employment:
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