STATE BANK OF INDIA CERTIFICATE TO BE SUBMITTED BY PENSIONER A) LIFE CERTIFICATE Certified that I have seen the pensioner Aci (Name of pensioner), holder of Pension Payment Order Ne oH arpbaazapza 2 and he (she is alive on this date. Savings Bank A/c No. Name & Designation of Authorised Officer 320393398 37 Specimen Signature of pensioner Seal B) NON-EMPLOYMENT CERTIFICATE XK # I declare that I have not received any remuneration for serving in any capacity in an establishment of Central Government or a State Government or a Government Undertaking or from a Local Pund during the period November to October_. YC # I declare that I have been employed / re-employed in the office of and was in receipt of the following emoluments during the period XH | declare that I have not accepted any employment under any Government outside India, after obtaining / without obtaining sanction of the EPF organization (to be furnished by Class I officer only) # Delete whichever is not applicable, y Signature, sbssry - Place: Ar cog Name of Pensioner Abeta | PPONo. 099705 /0014 24/20 (2. C) CERTIFICATE OF RE-MARRIAGE / NON-MARRIAGE Thereby declare that I am not married / have nof married during the past twelve months. Signature. = Place: AT SEA ‘Name of Pensioner ADH KAR PPONo. 0997 B/Oo1424]2012. [certify to the best of my knowledge and belief thatthe above declaration Signature pf a responsible office ogy son” Place: AT Seq Name: RO! 6 Date: 04.{1.2019 Designation: (a2 gf. Engi nece ‘ correct.SEAFARER EMPLOYMENT AGREEMENT BETWEEN $81 Caposica Shipping Company Limited (the “Shioowner ofthe vessel hereinbelow stated) ‘Trust Company Complex. Aptake Had Ajelake sian, . ageo69 Majo harsh isiancs AND surname © ADKIKARI Given Name =: ASHIMIKUMAR. (the "Seatarer") Dateof ith + ot/ani1973 Place of Birth: PATRASAYER STATION Passport number. 2407958 Dateofexpiry = 28/Fe02022 Seaman Book no, : MUM211B65 Date of expiry + 26iFe017023. Nationality lndian Cert of Competency: ETO Joining Port Parad Crew ID 49049 For service on board the vessel SSI Capovira (IMO No 8719537) of |_—-Marshallisands Flag (the "Vessel") which is managed by: ‘Scorpio Maritime India Privato Limited (the “Company” as defined in SM code) Chennai Inia Vessel type: Bulk Cartier 1, The terms and conditions applied fram commencement of service forthe duration shown below are in accordance with and subect to the following. Collective Bargaining Agreement the contents of which the Seafarer acknowledges as having rad, understood and agreed to: Applicable Collective Bargaining Agreement; MU! IBF MODEL CBA 2018 for Indian Officers ‘a copy of above CBA ison board the Vessel. Rank on board Port of engagement Duration of contract Wage starts from (date) Electr Techrical Offcer CHENNAL {5 (#1) Months at Shipowners option . *Not rom the date the Seafarer boards aninfematona fight o jin the Vessel under tis agreement a Remuneration per month (In US Dollar) Basie Monthly] Rank | Leave | Overtime Wage or Hourly] Pension | Subsistence | Trade Uniform — | Total Wage | Seniority | Wage OT Rate Fund | allowance | allowance | allowance | wage 4228.00 | 2,300.00 | 327.00 1,025.00 61.00 64.00 75.00 20.00 | 5,200.00 22. The wage and allowance elements inthis form are machine printed, any adtlons or alterations to those elements require the initials ofthe Seafarer and the Shipowners authorized agent), 3. Stand-by wages, amounting to USS _NA___are payable for _NA days in accordance withthe conditions of sevice refered to above 4. na _Level wages are applicable and payable from NA___ estimated date we) 5. Loyalty Sonus, ameunting to USS 75.0____pam.proratas applicable and peyable from __28iSo02019_(Estimated date #) 6. This agreementis automaticaly rendered null and vold, should for any reason, the Seafarer not travel to join the Vessel. 7. Incase of any higher revision of wages during the contact, the existing Owner Fidelity Allowance wil be adjusted accordingly, to meet the new wage scale. 8. ‘Since the above Vessels registered in Mashallands the parties to this contract hereby stipulate thatthe terms and conditions laid down herein ‘shall be subject tothe applicable provisions ofthe Maritime Law and Regulations ofthe Marshalllands Any dispute as te the terms and cantons of ths ‘contrac shal be resolved in accordance with the Martime Law and R ‘it Actual date wl depend on date of embarkation on Vessel and levels defined inapplicable wage scale lations of the erhalllanda, Soop eine Mnesreves (aa) Nesiony wetness ‘As agents only for and on behalf ofthe Shipowner hela sn ring by th Sone fhe et on wh yb aed hw ee 2 Gecauiica {Ge conpony ond any thes! ide, pean or mide ot esate ot aime oe © erga (eather eeret te ss “Canon forthe pups of my emer fpr! ow me canted rena raved by me ta ay fh amps + dt menor wep SanaTTe Sihtare informs open! ané peor sian empyema an end tomo hay lows erator oes seal to oy of he Corea her eins Tuned at a Name : CHOTA MOHAMMAD Name: ADHIKARI ASHIM KUMAR Place : CHENNAI Date :07/Aug/2018 Place : CHENAL Date :07/Augr2019 ‘site ore inthe conpan ete for he preety can haw ple meget by tongue fa, | sds that hearer he bere pers