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MINIMUM SAFE MANNING REQUIREMENTS

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					                                                                                                                          ANNEX IV
                     International Merchant Marine Registry of Belize
                                                                 “IMMARBE”
                        APPLICATION FOR MINIMUM SAFE MANNING CERTIFICATE

1. NAME OF VESSEL:
2. TYPE OF VESSEL:
3. REGISTRATION No:                                                  4.CALL LETTER :
5. IMO No :                                                        6.GROSS TONNAGE (ITC):
7. MACHINERY:
  MAIN ENGINE’S POWER (H.P): __ __________
 VESSEL CERTIFIED FOR UMS (UNATTENDED MACHINERY SPACE OPERATION):                                    NO          YES
  RADIO TELEPHONE:

  GMDSS EQUIPMENT:             A1         A1 + A2              A1+A2+A3     A1+A2+A3+A4
________________________________________________________________________________________________________
8. TYPE OF VOYAGE: PLEASE TICK IN THE BOX WHERE APPROPIATE                             9.TRADING AREA _______________________
                                                                                          _______________________________________
      SHORT VOYAGES (AS DEFINED IN SOLAS III/3.22)
                                                                                        _ ____________________________________
      COASTWISE TRADE (AS DEFINED IN S.I. No. 82 OF 1997)

      COASTAL TRADE (AS DEFINED IN S.I No. 82 OF 1997)

     UNRESTRICTED VOYAGES


AREAS AS DEFINED IN THE CARIBBEAN CARGO SHIP CODE

     RESTRICTED AREAI       RESTRICTED AREA II                   RESTRICTED AREA III       UNRESTRICTED VOYAGES X




10 MANNING COMPLEMENT         (FILL LIKE AS APPROPRIATE)




DECK                                                                  ENGINE
OFFICERS                       RATINGS                                ENGINEERS                          RATINGS
NO.     RANK                   NO.     RANK                           NO.    RANK                        NO.     RANK



     MASTER ( )                       BOSUN                               CHIEF ENG ( )                     WATCHKEEPING
                                                                                                            ENGINE RATING.( )
     CHIEF MATE ( )                 WATCHKEEPING                          SECOND ENG
                                    DECK RATING( )
    WATCHKEEPING OFF.                                                     WATCHKEEPING ENG.
    ( )                             DECK RATING(           )
     RADIO OFF.                                                           CHIEF ELECTR.
                                     COOK



         STATE ANY DEVIATION FROM MINIMUM STANDARDS:




     11. AFFIDAVIT OF APPLICANT
     I hereby affirm that all information provided by me in this application and its supporting documents and proofs
     are true and correct to the best of my knowledge and belief.


  12. APPLICANT’S SIGNATURE: ____________ 13. APPLICATION DATE:                                      _




         F-046-AMMC

				
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