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MAGNUS CARRIERS Form F06-10

CORPORATION
Issue Date: 01.09.05
Issue No: 02
SHORE BASED FAMILIARIZATION Rev. Date: ---
Rev. No: 00
Page: 1/4

General.

Master Chief Engineer Name:


Rank:
nd
Chief Officer 2 Engineer Ship to sign on:
Estimated sign on due date (if known):
Deck Officer Engineer Officer Estimated signb on port (if known):

Crew Pr. 06, Appendix 1 to be attached & refer to for Familiarization & Briefing Details.

Familiarization.

From date: to date: Policy Manual (L1):

Name of Agency or Company Office: Fleet Instructions (L3 \- A, B, C, D, E, F,G)

Familiarized by: Responsibilities

Declaration.

I (name), ………………………………………………… serving as (capacity / rank)……..………………………….

at (ship’s name) ………………………………………… hereby declare that:

I have been familiarized with the above-mentioned parts of Company Tanker Quality Management System
related to my rank and service capacity onboard mentioned ship, as described in the “Familiarization
Scheme of Newly Employed Seamen”.

______________________________ _____________________

(Name & Signature) (Date)

………………………………………………………………………………………………………………………………
FOR OFFICE USE ONLY

Signed in presence of: (Name & Capacity) ___________________________ on (date) _________________

Returned to Human Resources Director by ___________________________ on (date)_________________


MAGNUS CARRIERS Form F06-10
CORPORATION
Issue Date: 01.09.05
Issue No: 02
SHORE BASED FAMILIARIZATION Rev. Date: ---
Rev. No: 00
Page: 2/4

General Policy Acceptance Clause.

I (name), ………………………………………………… serving as (capacity / rank)……..………………………….

at (ship’s name) ………………………………………… hereby declare that:

1. Company Policies described in detail in the policy manual have been have been received and fully
understood.

2. I am aware of my responsibilities related thereof in particular, I understand and accept to fully adapt
and implement all parts of Policies & Company Instructions and regulations related to my time of
service and agree to proceed with any actions under my responsibility to ensure that safety, health
and the protection of the environment is maintained.

3. I am fully competent to carry out all Duties, which have been assigned to me.

______________________________ _____________________

(Name & Signature) (Date)

………………………………………………………………………………………………………………………………
FOR OFFICE USE ONLY

Signed in presence of: (Name & Capacity) ___________________________ on (date) _________________

Returned to Human Resources Director by ___________________________ on (date)_________________


MAGNUS CARRIERS Form F06-10
CORPORATION
Issue Date: 01.09.05
Issue No: 02
SHORE BASED FAMILIARIZATION Rev. Date: ---
Rev. No: 00
Page: 3/4

Liability Clause.

I (name), ………………………………………………… serving as (capacity / rank)……..………………………….

at (ship’s name) ………………………………………… hereby declare that I will not:

1. Disclose any information, regarding projects, reports or any work carried for, or on behalf of UNIBROS
SHIPPING CORP., to anyone outside the employment of the company, or anyone not involved with the
aforementioned work.

2. Divulge any information to anyone, regarding confidential files / documents, which I may be asked to
read or work on for any work which I am involved in.

3. Take any property belonging to Magnus Carriers Co., from the premises, without first receiving written
permission to do so.

4. Photocopy, or copy any documents / reports / books, etc., without prior permission.

______________________________ _____________________

(Name & Signature) (Date)

………………………………………………………………………………………………………………………………
FOR OFFICE USE ONLY

Signed in presence of: (Name & Capacity) ___________________________ on (date) _________________

Returned to Human Resources Director by ___________________________ on (date)_________________


MAGNUS CARRIERS Form F06-10
CORPORATION
Issue Date: 01.09.05
Issue No: 02
SHORE BASED FAMILIARIZATION Rev. Date: ---
Rev. No: 00
Page: 4/4

Special Policy Acceptance Clause.

I (name), ………………………………………………… serving as (capacity / rank)……..………………………….

at (ship’s name) ………………………………………… hereby declare that:

1. DRUG & ALCOHOL POLICY

The Drug and Alcohol Policy issued by Principals on behalf of the Owners of the above vessels per copy
attached hereto.

I undertake to adhere to that policy and I agree to be bound by all of the rules and guidelines
with it including but not limited to the provisions for random testing and during my service with
any vessels in the agency of our principals.

2. HEALTH SAFETY AND ENVIRONMENTAL PROTECTION POLICY

The Health Safety Environmental Policy issued by Principals on behalf of the Owners of the above
vessel as per copy attached hereto. I undertake to adhere and I agree to be bound by all of the rules
and guidelines associated with during my service with any vessels.

If I am found violating the Company’s Policy or procedures relating to drugs and alcohol – health safety
& environmental protection, I am subject to disciplinary action, up to and including dismissal, as decided
by Master of the vessel, and / or the responsible person(s) in the Company’s office ashore.

______________________________ _____________________

(Name & Signature) (Date)

………………………………………………………………………………………………………………………………
FOR OFFICE USE ONLY

Signed in presence of: (Name & Capacity) ___________________________ on (date) _________________

Returned to Human Resources Director by ___________________________ on (date)_________________