Date

MARITIME INDUSTRY AUTHORITY

3rd Floor Tan Bldg. Quezon Avenue
Sevilla Center, San Fernando City
La Union

Attention : ENGR. JUAN DELA CRUZ

Position

Subject: : REQUEST FOR ISSUANCE OF SPECIAL PERMIT

TO NAVIGATE BARGE “NAME OF BARGE”

Dear Sir:

We would like to request for the issuance of “Special Permit to Navigate” for SB
Construction Corp Barge equipment _____ in regard to its Cargo Ship Safety and
Minimum Safe Manning Certificate expiring on July 11, 2018. The subject barge is now
in Quezon Province and scheduled for dry docking to Navotas, Manila. Relative thereto,
M/Tug “MCRP 33” will assist voyage of the said barge ______.

Enclosed please find the current Certificate of Ownership, Certificate of Philippine

Registry, Cargo Ship Safety and Minimum Safe Manning Certificate of Barge “______”
and M/Tug MCRP 33.

Thank you for accommodating our request.

Very truly yours,

_________________
Xxxxx
Managing Director