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Prc-Mdo Form 5 Blank
Prc-Mdo Form 5 Blank
supervision on board
MV STAR DRIVANGER
(Name of Vessel)
387775
for a period of
(No. of Years)
as
JOHN R. JAROMAHUM
, BULK CARRIER of
(Type of Vessel)
SEA GOING
(Near Coastal/Seagoing)
8
(Months)
vessel of
27735
22 from
4-Feb-99
to
(Days)
(Date of Embarkation)
gross tonnage
26-Oct-99
(Date of Discharge)
3rd Mate
(Position Held)
This certifies further that the above-stated data are all true and that any false statement/s made
526-8888/526-9692/5269724
:__________
:__________
:__________
:__________
NOTARY PUBLIC
Note: This form is good only for (1) Vessel. This form can be reproduced. Any erasure/
obliteration may be a ground for denial.
FOR SALE
under our
f Vessel)
ross tonnage
9
harge)
supervision on board
MV STAR DROTTANGER
(Name of Vessel)
387776
for a period of
(No. of Years)
as
JOHN R. JAROMAHUM
, BULK CARRIER of
(Type of Vessel)
SEA GOING
(Near Coastal/Seagoing)
7
(Months)
vessel of
27735
20 from
5-Feb-00
to
(Days)
(Date of Embarkation)
gross tonnage
25-Sep-00
(Date of Discharge)
3rd Mate
(Position Held)
This certifies further that the above-stated data are all true and that any false statement/s made
526-8888/526-9692/5269724
:__________
:__________
:__________
:__________
NOTARY PUBLIC
Note: This form is good only for (1) Vessel. This form can be reproduced. Any erasure/
obliteration may be a ground for denial.
FOR SALE
under our
f Vessel)
ross tonnage
00
harge)
supervision on board
,
(Name of Vessel)
of
(Type of Vessel)
vessel of
gross tonnage
(Near Coastal/Seagoing)
for a period of
from
(No. of Years)
(Months)
(Days)
to
(Date of Embarkation)
(Date of Discharge)
as
(Position Held)
This certifies further that the above-stated data are all true and that any false statement/s made
Telephone Nos.
:__________
:__________
:__________
:__________
NOTARY PUBLIC
Note: This form is good only for (1) Vessel. This form can be reproduced. Any erasure/
obliteration may be a ground for denial.
OT FOR SALE
ed under our
ty of Vessel)
gross tonnage
ischarge)